Preterm brain injury and neurodevelopmental outcomes: a meta-analysis
File(s)
Published version
Author(s)
Type
Journal Article
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 2000-2021
Study Selection:
Observational studies reporting 3-year neurodevelopmental outcomes for preterm infants with IVH or WMI compared to preterm infants without injury.
Data extraction:
Study characteristics, population characteristics, and outcome data were extracted.
Results:
38 studies were included. There was an increased adjusted risk of moderate-severe neurodevelopmental impairment after IVH grade 1-2 (aOR 1.35 [95% CI 1.05, 1.75]) and IVH grade 3-4 (aOR 4.26 [3.25, 5.59]). Children with IVH grade 1-2 had higher risks of cerebral palsy (OR 1.76 [1.39, 2.24)], cognitive (OR 1.79 [1.09, 2.95]), hearing (OR 1.83 CI [1.03. 3.24]), and visual impairment (OR 1.77 [1.08, 2.9]). Children with IVH grade 3-4 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 outcomes sets and availability of open-access study data would improve our understanding of the nuances of these outcomes.
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 2000-2021
Study Selection:
Observational studies reporting 3-year neurodevelopmental outcomes for preterm infants with IVH or WMI compared to preterm infants without injury.
Data extraction:
Study characteristics, population characteristics, and outcome data were extracted.
Results:
38 studies were included. There was an increased adjusted risk of moderate-severe neurodevelopmental impairment after IVH grade 1-2 (aOR 1.35 [95% CI 1.05, 1.75]) and IVH grade 3-4 (aOR 4.26 [3.25, 5.59]). Children with IVH grade 1-2 had higher risks of cerebral palsy (OR 1.76 [1.39, 2.24)], cognitive (OR 1.79 [1.09, 2.95]), hearing (OR 1.83 CI [1.03. 3.24]), and visual impairment (OR 1.77 [1.08, 2.9]). Children with IVH grade 3-4 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 outcomes sets and availability of open-access study data would improve our understanding of the nuances of these outcomes.
Date Issued
2022-11-04
Date Acceptance
2022-07-08
Citation
Pediatrics, 2022, 150 (6), pp.1-15
ISSN
0031-4005
Publisher
American Academy of Pediatrics
Start Page
1
End Page
15
Journal / Book Title
Pediatrics
Volume
150
Issue
6
Copyright Statement
© 2022 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License .
License URL
Identifier
https://publications.aap.org/pediatrics/article/150/6/e2022057442/189905/Preterm-Brain-Injury-and-Neurodevelopmental?autologincheck=redirected
Publication Status
Published
Date Publish Online
2022-11-04