Risk Factor Effects on Neurodevelopment at 2 Years in Very Preterm Children: A Systematic Review.

IF 6.2 2区医学 Q1 PEDIATRICS

Pediatrics Pub Date : 2025-05-15 DOI:10.1542/peds.2024-069565

Samuel B Axford,Alice C Burnett,Abdulbasit M Seid,Peter J Anderson,Jamie L Waterland,Courtney P Gilchrist,Joy E Olsen,Thi-Nhu-Ngoc Nguyen,Lex W Doyle,Jeanie L Y Cheong

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引用次数: 0

Abstract

CONTEXT Various medical and social factors are associated with adverse neurodevelopment in children born very preterm. Analyses accounting for confounders involving representative samples are essential to quantify the effects of different factors. OBJECTIVE We aimed to systematically review the effects of various risk factors on neurodevelopmental impairment (NDI) at 18 to 36 months of age in children born before 32 weeks' gestation. DATA SOURCES Ovid MEDLINE, Embase, and PubMed were searched for articles up through April 29, 2024. STUDY SELECTION We used geographic or network population cohort studies of children born after January 1, 1990 at less than 32 completed weeks' gestation reporting risk factors and NDI measures at 18 to 36 months old. Studies including less than 50 children, not addressing confounders in the analysis, or comprising nonrepresentative samples were excluded. DATA EXTRACTION Study characteristics, population characteristics, exposure and outcome definitions, effect sizes, and covariates were extracted. RESULTS Of 18 012 studies screened, 51 were eligible. Brain injury (intraventricular hemorrhage grade III or IV and/or periventricular leukomalacia) had the highest adjusted odds of moderate-to-severe NDI and its main contributors (moderate-to-severe cognitive or language delay and moderate-to-severe cerebral palsy), followed by neonatal seizures and retinopathy of prematurity (≥stage 3, "threshold disease" or "treated"). Small for gestational age exhibited inconsistent effects, whereas lower maternal age exhibited no effect on the outcomes included. LIMITATIONS This included an inability to meta-analyze due to factor and outcome definition heterogeneity. CONCLUSIONS This review illustrates the extent to which risk factors influence the odds of NDI in children born very preterm, finding neurologic morbidities confer the highest risk. We highlight the need for consistent factor and outcome definitions.

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危险因素对2岁极早产儿神经发育的影响：一项系统综述。

各种医学和社会因素与极早产儿童的不良神经发育有关。分析涉及代表性样本的混杂因素对于量化不同因素的影响至关重要。目的系统回顾各种危险因素对妊娠32周前出生的18 ~ 36月龄儿童神经发育障碍（NDI）的影响。数据来源我们检索了截止到2024年4月29日的文章：MEDLINE， Embase和PubMed。研究选择：我们采用地理或网络人群队列研究，研究对象为1990年1月1日以后出生、妊娠少于32周的儿童，报告危险因素和18至36个月时的NDI测量。包括少于50名儿童的研究，未处理分析中的混杂因素，或包含非代表性样本的研究被排除在外。提取研究特征、人群特征、暴露和结果定义、效应量和协变量。结果18012项研究中，51项符合条件。脑损伤（III级或IV级脑室内出血和/或脑室周围白质软化症）发生中至重度NDI及其主要原因（中至重度认知或语言迟缓和中至重度脑瘫）的调整后几率最高，其次是新生儿癫痫发作和早产儿视网膜病变（≥3期，“阈值疾病”或“治疗”）。小胎龄表现出不一致的影响，而较低的母亲年龄对包括的结果没有影响。这包括由于因素和结果定义的异质性而无法进行meta分析。结论：本综述阐述了风险因素对极早产儿童NDI发生率的影响程度，发现神经系统疾病是最高风险因素。我们强调需要一致的因素和结果定义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics 医学-小儿科

CiteScore

12.80

自引率

5.00%

发文量

791

审稿时长

2-3 weeks

期刊介绍： The Pediatrics® journal is the official flagship journal of the American Academy of Pediatrics (AAP). It is widely cited in the field of pediatric medicine and is recognized as the leading journal in the field. The journal publishes original research and evidence-based articles, which provide authoritative information to help readers stay up-to-date with the latest developments in pediatric medicine. The content is peer-reviewed and undergoes rigorous evaluation to ensure its quality and reliability. Pediatrics also serves as a valuable resource for conducting new research studies and supporting education and training activities in the field of pediatrics. It aims to enhance the quality of pediatric outpatient and inpatient care by disseminating valuable knowledge and insights. As of 2023, Pediatrics has an impressive Journal Impact Factor (IF) Score of 8.0. The IF is a measure of a journal's influence and importance in the scientific community, with higher scores indicating a greater impact. This score reflects the significance and reach of the research published in Pediatrics, further establishing its prominence in the field of pediatric medicine.