Alice Burnett, Samuel B Axford, Abdulbasit M Seid, Peter J Anderson, Jamie L Waterland, Courtney P Gilchrist, Joy Olsen, Ngoc Nguyen, Alicia Spittle, Lex W Doyle, Jeanie Ling Yoong Cheong
{"title":"Predicting long-term neurodevelopmental outcomes for children born very preterm: a systematic review.","authors":"Alice Burnett, Samuel B Axford, Abdulbasit M Seid, Peter J Anderson, Jamie L Waterland, Courtney P Gilchrist, Joy Olsen, Ngoc Nguyen, Alicia Spittle, Lex W Doyle, Jeanie Ling Yoong Cheong","doi":"10.1136/archdischild-2025-328891","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Children born very preterm (<32 weeks' gestation) have increased risk of neurodevelopmental difficulties compared with those born at term. While various neonatal exposures have been linked with later developmental challenges, identifying those at risk of difficulties later in childhood remains a challenge but is essential for targeting early intervention and counselling families.</p><p><strong>Objective: </strong>To systematically review and synthesise the evidence regarding early medical and environmental factors for neurodevelopmental impairment, cognitive, motor and behavioural outcomes for children born very preterm.</p><p><strong>Design: </strong>Ovid MEDLINE, Embase and PubMed were searched for articles between 1 January 1990 and 29 April 2024 reporting on a representative, prospective geographical, network-based or multisite cohorts of children born <32 weeks' gestation.</p><p><strong>Main outcome measures: </strong>Neurodevelopmental impairment, cognitive, motor and emotional-behavioural functioning in children aged 36 months to 18 years. Data were extracted and reported descriptively due to heterogeneity in study measures.</p><p><strong>Results: </strong>From 18 012 records, 29 studies from 16 cohorts were included. Brain injury, bronchopulmonary dysplasia, male sex and lower socioeconomic status were the most consistent predictors of neurodevelopmental impairment, IQ, working memory, cerebral palsy, fine motor skills and some behavioural measures. Emotional problems were generally not associated with neonatal variables investigated to date.</p><p><strong>Conclusion: </strong>Numerous factors are independently associated with childhood outcomes after being born very preterm, with specific predictors varying across domains of functioning and limited available evidence for some predictor-outcome combinations. Knowledge of these factors may assist in targeting those at highest risk for closer surveillance and early intervention.PROSPERO registration numberCRD42022368957.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Disease in Childhood - Fetal and Neonatal Edition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/archdischild-2025-328891","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Context: Children born very preterm (<32 weeks' gestation) have increased risk of neurodevelopmental difficulties compared with those born at term. While various neonatal exposures have been linked with later developmental challenges, identifying those at risk of difficulties later in childhood remains a challenge but is essential for targeting early intervention and counselling families.
Objective: To systematically review and synthesise the evidence regarding early medical and environmental factors for neurodevelopmental impairment, cognitive, motor and behavioural outcomes for children born very preterm.
Design: Ovid MEDLINE, Embase and PubMed were searched for articles between 1 January 1990 and 29 April 2024 reporting on a representative, prospective geographical, network-based or multisite cohorts of children born <32 weeks' gestation.
Main outcome measures: Neurodevelopmental impairment, cognitive, motor and emotional-behavioural functioning in children aged 36 months to 18 years. Data were extracted and reported descriptively due to heterogeneity in study measures.
Results: From 18 012 records, 29 studies from 16 cohorts were included. Brain injury, bronchopulmonary dysplasia, male sex and lower socioeconomic status were the most consistent predictors of neurodevelopmental impairment, IQ, working memory, cerebral palsy, fine motor skills and some behavioural measures. Emotional problems were generally not associated with neonatal variables investigated to date.
Conclusion: Numerous factors are independently associated with childhood outcomes after being born very preterm, with specific predictors varying across domains of functioning and limited available evidence for some predictor-outcome combinations. Knowledge of these factors may assist in targeting those at highest risk for closer surveillance and early intervention.PROSPERO registration numberCRD42022368957.
期刊介绍:
Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.