Long-term cognition and behavior in children born at early term gestation: a systematic review.
Acta Obstet Gynecol Scand. 2019 May 15;:
Authors: Nielsen TM, Pedersen MV, Milidou I, Glavind J, Henriksen TB
INTRODUCTION: Recent recommendations characterize deliveries at 37 weeks 0 days through 38 weeks 6 days as early term. We aimed to systematically review the literature on long-term cognition, school performance, and behavior in children born early term (37 weeks 0 days to 38 weeks 6 days) compared with full term (39 weeks 0 days to 40 weeks 6 days).
MATERIAL AND METHODS: The review was performed according to the PRISMA Statement. The final literature search was performed on the 31st of January 2019. We located studies in PubMed, Embase, CINAHL, and Cochrane Library. Eligible studies were randomised controlled trials, cohort studies, and case-control studies, with outcome assessment performed at two to nineteen years. We collected information using a structured data form and evaluated study quality using the Newcastle-Ottawa Scale (NOS).
RESULTS: We included 42 observational studies published between 2006 and 2018. No restriction to year of publication was made. The mean NOS score was 5.8 with a range from three to nine. Compared to children born full term, children born early term had a lower intelligence score in early adulthood and up to some 30% increased risk of attention-deficit/hyperactivity disorder. Furthermore, we found some 10-40% increased risk of cognitive problems, some 25% higher risk of language impairments, and 8-75% more with poorer overall school performance. No meta-analysis was conducted due to heterogeneity in the outcome measures. Only ten studies presented subgroup analyses in spontaneous deliveries or adjusted for type of labor onset/induction.
CONCLUSIONS: Children born early term are at increased risk of cognitive deficits, poorer school performance, and behavioral problems compared to children born full term. This article is protected by copyright. All rights reserved.
PMID: 31091336 [PubMed – as supplied by publisher]