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Preterm Brain Injury and Neurodevelopmental Outcomes: A Meta-analysis.
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![loading](/sites/all/modules/hf_eds/images/loading.gif)
- Author(s): Rees, Philippa; Callan, Caitriona; Chadda, Karan R.; Vaal, Meriel; Diviney, James; Sabti, Shahad; Harnden, Fergus; Gardiner, Julian; Battersby, Cheryl; Gale, Chris; Sutcliffe, Alastair
- Source:
Pediatrics. Dec2022, Vol. 150 Issue 6, p1-15. 61p. - Source:
- Additional Information
- Subject Terms: COGNITION disorder risk factors; CHILD development deviations -- Risk factors; INFANT development; CEREBRAL hemorrhage; META-analysis; CONFIDENCE intervals; SYSTEMATIC reviews; DEVELOPMENTAL disabilities; MOVEMENT disorders; NEURAL development; WHITE matter (Nerve tissue); RISK assessment; COMPARATIVE studies; DESCRIPTIVE statistics; HEARING disorders; RESEARCH funding; BRAIN injuries; MEDLINE; ODDS ratio; CEREBRAL palsy; VISION disorders; DISEASE risk factors; DISEASE complications; CHILDREN
- Abstract: CONTEXT: Preterm brain injuries are common; neurodevelopmental outcomes following contemporary neonatal care are continually evolving. OBJECTIVE: To systematically review and meta-analyze neurodevelopmental outcomes among preterm infants after intraventricular hemorrhage (IVH) and white matter injury (WMI). DATA SOURCES: Published and grey literature were searched across 10 databases between 2000 and 2021. STUDY SELECTION: Observational studies reporting 3-year neurodevelopmental outcomes for preterm infants with IVH or WMI compared with preterm infants without injury. DATA EXTRACTION: Study characteristics, population characteristics, and outcome data were extracted. RESULTS: Thirty eight studies were included. There was an increased adjusted risk of moderate-severe neurodevelopmental impairment after IVH grade 1 to 2 (adjusted odds ratio 1.35 [95% confidence interval 1.05-1.75]) and IVH grade 3 to 4 (adjusted odds ratio 4.26 [3.25-5.59]). Children with IVH grade 1 to 2 had higher risks of cerebral palsy (odds ratio [OR] 1.76 [1.39-2.24]), cognitive (OR 1.79 [1.09-2.95]), hearing (OR 1.83 [1.03-3.24]), and visual impairment (OR 1.77 [1.08-2.9]). Children with IVH grade 3 to 4 had markedly higher risks of cerebral palsy (OR 4.98 [4.13-6.00]), motor (OR 2.7 [1.52-4.8]), cognitive (OR 2.3 [1.67-3.15]), hearing (OR 2.44 [1.42-4.2]), and visual impairment (OR 5.42 [2.77-10.58]). Children with WMI had much higher risks of cerebral palsy (OR 14.91 [7.3-30.46]), motor (OR 5.3 [3-9.36]), and cognitive impairment (OR 3.48 [2.18-5.53]). LIMITATIONS: Heterogeneity of outcome data. CONCLUSIONS: Mild IVH, severe IVH, and WMI are associated with adverse neurodevelopmental outcomes. Utilization of core outcome sets and availability of open-access study data would improve our understanding of the nuances of these outcomes. [ABSTRACT FROM AUTHOR]
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