{"title":"Neonatal care and developmental outcomes following preterm birth: A systematic review and meta-analysis.","authors":"Or Burstein, Tamara Aryeh, Ronny Geva","doi":"10.1037/dev0001844","DOIUrl":null,"url":null,"abstract":"<p><p>Major amendments in neonatal care have been introduced in recent decades. It is important to understand whether these amendments improved the cognitive sequelae of preterm children. Through a large-scale meta-analysis, we explored the association between prematurity-related complications, neonatal care quality, and cognitive development from birth until 7 years. MEDLINE, APA PsycInfo, and EBSCO were searched. Peer-reviewed studies published between 1970 and 2022 using standardized tests were included. We evaluated differences between preterm and full-term children in focal developmental domains using random-effects meta-analyses. We analyzed data from 161 studies involving 39,799 children. Preterm birth was associated with inferior outcomes in global cognitive development (standardized mean difference = -0.57, 95% CI [-0.63, -0.52]), as well as in language/communication, visuospatial, and motor performance, reflecting mean decreases of approximately 7.3 to 9.3 developmental/intelligence quotients. Extreme prematurity, neonatal pulmonary morbidities, and older assessment age in very-to-extreme preterm cohorts were associated with worse outcomes. Contemporary neonatal medical and developmental care were associated with transient improvements in global cognitive development, evident until 2 to 3 years of age but not after. Blinding of examiners to participants' gestational background was associated with poorer outcomes in preterm cohorts, suggesting the possibility of a \"compassion bias.\" The results suggest that preterm birth remains associated with poorer cognitive development in early childhood, especially following pulmonary diseases and very-to-extreme preterm delivery. Importantly, deficits become more pervasive with age, but only after births before 32 gestational weeks and not in moderate-to-late preterm cohorts. Care advancements show promising signs of promoting resiliency in the early years but need further refinements throughout childhood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":48464,"journal":{"name":"Developmental Psychology","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Developmental Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/dev0001844","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, DEVELOPMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Major amendments in neonatal care have been introduced in recent decades. It is important to understand whether these amendments improved the cognitive sequelae of preterm children. Through a large-scale meta-analysis, we explored the association between prematurity-related complications, neonatal care quality, and cognitive development from birth until 7 years. MEDLINE, APA PsycInfo, and EBSCO were searched. Peer-reviewed studies published between 1970 and 2022 using standardized tests were included. We evaluated differences between preterm and full-term children in focal developmental domains using random-effects meta-analyses. We analyzed data from 161 studies involving 39,799 children. Preterm birth was associated with inferior outcomes in global cognitive development (standardized mean difference = -0.57, 95% CI [-0.63, -0.52]), as well as in language/communication, visuospatial, and motor performance, reflecting mean decreases of approximately 7.3 to 9.3 developmental/intelligence quotients. Extreme prematurity, neonatal pulmonary morbidities, and older assessment age in very-to-extreme preterm cohorts were associated with worse outcomes. Contemporary neonatal medical and developmental care were associated with transient improvements in global cognitive development, evident until 2 to 3 years of age but not after. Blinding of examiners to participants' gestational background was associated with poorer outcomes in preterm cohorts, suggesting the possibility of a "compassion bias." The results suggest that preterm birth remains associated with poorer cognitive development in early childhood, especially following pulmonary diseases and very-to-extreme preterm delivery. Importantly, deficits become more pervasive with age, but only after births before 32 gestational weeks and not in moderate-to-late preterm cohorts. Care advancements show promising signs of promoting resiliency in the early years but need further refinements throughout childhood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
期刊介绍：
Developmental Psychology ® publishes articles that significantly advance knowledge and theory about development across the life span. The journal focuses on seminal empirical contributions. The journal occasionally publishes exceptionally strong scholarly reviews and theoretical or methodological articles. Studies of any aspect of psychological development are appropriate, as are studies of the biological, social, and cultural factors that affect development. The journal welcomes not only laboratory-based experimental studies but studies employing other rigorous methodologies, such as ethnographies, field research, and secondary analyses of large data sets. We especially seek submissions in new areas of inquiry and submissions that will address contradictory findings or controversies in the field as well as the generalizability of extant findings in new populations. Although most articles in this journal address human development, studies of other species are appropriate if they have important implications for human development. Submissions can consist of single manuscripts, proposed sections, or short reports.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
