Cognitive outcomes of children born extremely or very preterm since the 1990s and associated risk factors
| Autor: | Rebecca M. Wade, E. Sabrina Twilhaar, Jaap Oosterlaan, Johannes B. van Goudoever, Ruurd M. van Elburg, Jorrit F. de Kieviet |
|---|---|
| Přispěvatelé: | Neonatology, Other departments, General Paediatrics, ARD - Amsterdam Reproduction and Development, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Clinical Neuropsychology, IBBA, APH - Mental Health, Rehabilitation medicine, Pediatric surgery, ACS - Diabetes & metabolism, AGEM - Endocrinology, metabolism and nutrition, Amsterdam Reproduction & Development (AR&D) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pediatrics
medicine.medical_specialty Birth weight Intelligence Gestational Age 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Interquartile range 030225 pediatrics Intellectual Disability medicine Journal Article Humans Infant Very Low Birth Weight Very Preterm Birth Meta-regression Cognitive impairment Birth Year Bronchopulmonary Dysplasia business.industry Extremely preterm Infant Newborn Gestational age Obstetrics and Gynecology Cognition General Medicine medicine.disease Very preterm Low birth weight Bronchopulmonary dysplasia Infant Extremely Low Birth Weight Infant Extremely Premature Meta-analysis Pediatrics Perinatology and Child Health Small for gestational age Gestation medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Twilhaar, E S, Wade, R M, de Kieviet, J F, van Goudoever, J B, van Elburg, R M & Oosterlaan, J 2018, ' Cognitive Outcomes of Children Born Extremely or Very Preterm since the 1990s and Associated Risk Factors: A Meta-analysis and Meta-regression ', Obstetrical and Gynecological Survey, vol. 73, no. 10, pp. 562-563 . https://doi.org/10.1097/01.ogx.0000547169.91377.70 JAMA pediatrics, 172(4), 361-367. American Medical Association Obstetrical and Gynecological Survey, 73(10), 562-563. Lippincott Williams and Wilkins JAMA Pediatrics, 172(4), 361-367. American Medical Association Twilhaar, E S, Wade, R M, De Kieviet, J F, Van Goudoever, J B, Van Elburg, R M & Oosterlaan, J 2018, ' Cognitive Outcomes of Children Born Extremely or Very Preterm since the 1990s and Associated Risk Factors : A Meta-analysis and Meta-regression ', Obstetrical and Gynecological Survey, vol. 73, no. 10, pp. 562-563 . https://doi.org/10.1097/01.ogx.0000547169.91377.70 Twilhaar, E S, Wade, R M, De Kieviet, J F, Van Goudoever, J B, Van Elburg, R M & Oosterlaan, J 2018, ' Cognitive outcomes of children born extremely or very preterm since the 1990s and associated risk factors : A meta-analysis and meta-regression ', JAMA Pediatrics, vol. 172, no. 4, pp. 361-367 . https://doi.org/10.1001/jamapediatrics.2017.5323 Obstetrical & gynecological survey, 73(10), 562-563. Lippincott Williams and Wilkins Twilhaar, E S, Wade, R M, de Kieviet, J F, van Goudoever, J B, van Elburg, R M & Oosterlaan, J 2018, ' Cognitive outcomes of children born extremely or very preterm since the 1990s and associated risk factors: A meta-analysis and meta-regression ', JAMA Pediatrics, vol. 172, no. 4, pp. 361-367 . https://doi.org/10.1001/jamapediatrics.2017.5323 |
| ISSN: | 2168-6203 2168-6211 0029-7828 |
| Popis: | Importance: Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth.Objective: To examine the cognitive abilities of children of EP/VP birth (EP/VP children) and the role of perinatal and demographic risk factors.Data Sources: PubMed, Web of Science, and PsycINFO were searched without language restriction (last search March 2, 2017). Key search terms included preterm, low birth weight, and intelligence.Study Selection: Peer-reviewed studies reporting intelligence scores of EP/VP children (Data Extraction and Synthesis: MOOSE guidelines were followed. Data were independently extracted by 2 researchers. Standardized mean differences in intelligence per study were pooled using random-effects meta-analysis. Heterogeneity in effect size across studies was studied using multivariate, random-effects meta-regression analysis.Main Outcomes and Measures: Primary outcome was intelligence. Covariates included gestational age, birth weight, birth year, age at assessment, sex, race/ethnicity, socioeconomic status, small for gestational age, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, sepsis, and postnatal corticosteroid use.Results: The 71 included studies comprised 7752 EP/VP children and 5155 controls. Median gestational age was 28.5 weeks (interquartile range [IQR], 2.4 weeks) and the mean age at assessment ranged from 5.0 to 20.1 years. The median proportion of males was 50.0% (IQR, 8.7%). Preterm children had a 0.86-SD lower IQ compared with controls (95% CI, -0.94 to -0.78, P Conclusions and Relevance: Extremely or very preterm children born in the antenatal corticosteroids and surfactant era show large deficits in intelligence. No improvement in cognitive outcome was observed between 1990 and 2008. These findings emphasize that improving outcomes after EP/VP birth remains a major challenge. Bronchopulmonary dysplasia was found to be a crucial factor for cognitive outcome. Lowering the high incidence of BPD may be key to improving long-term outcomes after EP/VP birth. |
| Databáze: | OpenAIRE |
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