ArticleFrontiers in reproductive health2025
Sociodemographic characteristics and predictive factors of attrition: comparison in two final waves of a birth cohort study in Ecuador.
Article in Frontiers in reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Birth cohort studies are essential to investigate maternal and child health outcomes, yet they face persistent methodological challenges. A major concern is attrition, as participant loss over successive waves can compromise validity and introduce bias. These challenges are particularly acute in low- and middle-income countries, where socioeconomic inequalities and structural barriers further exacerbate participant loss and complicate long-term follow-up. Objective: This paper compares attrition between participants who remained and those who dropped out of the birth cohort study, SEMILLA. We analyze reasons for drop out, and the sociodemographic characteristics and predictive factors associated with attrition. Material and methods: Recruitment occurred over 30 months. Events such as the COVID-19 pandemic and social conflicts between 2019 and 2022 affected the final follow-up. The baseline sample included 409 pregnant women, divided into two Final Waves (FW): FW1 completed participation up to the baby's 12 months ( Results: Of 409 participants, 94 dropped out: 19 in FW1 and 75 in FW2. The main reasons were protocol non-compliance (54%), voluntary withdrawal (21%), miscarriage (13%), and loss to follow-up (12%). In FW1, younger age was associated with attrition ( Conclusion: Dropouts increased with longer follow-up, mainly due to time constraints. Age and income disparities significantly predicted continued participation. In contexts with socioeconomic challenges, these factors also affected protocol compliance. Findings underscore the importance of addressing socioeconomic determinants to strengthen the validity and sustainability of longitudinal studies in similar settings.
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