Developmental outcomes and quality of life in children born preterm at preschool- and school-age

Abstract

Objective: To review literature published in the last 5 years on the effects of premature birth on the development and quality of life of preschool-and school-age children.Source: Systematic review of empirical studies published in the last 5 years and indexed on PubMed, MEDLINE, LILACS, SciELO and PsycINFO. Keywords were chosen that relate prematurity to developmental and quality of life outcomes. Summary of the findings:In the studies chosen, four global indicators of development were identified (neurological, neurodevelopment, executive functions and quality of life), in addition to seven specific indicators of development (cognition, motor function, behavior, language, academic performance, attention and memory). The most prevalent indicators were cognition and motor function. Premature children had worse performance in all developmental indicators than children born full term. Additionally, the younger the gestational age, the worse the performance in developmental indicator assessments. The studies identified both risk factors (lower birth weight, intraventricular hemorrhage and low maternal educational level) and protective factors (larger head circumference, breastfeeding and higher family income) for development of children born preterm. Conclusion ResumoObjetivo: Revisar a literatura publicada nos últimos 5 anos sobre o efeito do nascimento prematuro no desenvolvimento e qualidade de vida de crianças nas fases pré-escolar e escolar. Fonte dos dados:Revisão sistemática de estudos empíricos dos últimos 5 anos indexados nas bases de dados PubMed, MEDLINE, LILACS, SciELO e PsycINFO. Utilizaram-se palavras-chave que associaram a prematuridade aos desfechos de desenvolvimento e qualidade de vida. Síntese dos dados:Nos estudos, foram identificados quatro indicadores globais do desenvolvimento (neurológico, neurodesenvolvimento, funções executivas e qualidade de vida) e sete indicadores específicos do desenvolvimento (cognição, motor, comportamento, linguagem, desempenho escolar, atenção e memória). Os indicadores mais prevalentes foram cognição e motor. Os prematuros apresentaram pior desempenho em todos os indicadores de desenvolvimento quando comparados às crianças nascidas a termo. Além disso, quanto menor a idade gestacional, pior o desempenho nas avaliações dos indicadores de desenvolvimento. Verificou-se a presença de fatores de risco (menor peso ao nascer, hemorragia intraventricular e baixo nível educacional da mãe) e fatores de proteção (maior perímetro cefálico, aleitamento materno e maior renda familiar) do desenvolvimento de crianças nascidas pré-termo. Conclusão:Crianças nascidas com prematuridade extrema (≤ 30 semanas de idade gestacional) são vulneráveis para apresentar problemas no desenvolvimento e na qualidade de vida.J Pediatr (Rio J). 2011;87(4):281-291: Desenvolvimento infantil, qualidade de vida, prematuro.

Recent advances in nutrition, genes and brain health

“…Intrauterine growth restriction (IUGR) is a naturally occurring form of prenatal undernutrition, with several different causes, that reflects a reduction in nutrient supply to the fetus. Infants born small-for-gestational age, especially when they are also preterm, are at major risk of impaired neurodevelopment, multiple cognitive deficits, mental health problems and schizophrenia in later life (1,2,(82)(83)(84) . Findings on epigenetic changes induced by prenatal famine exposure (81) raise the possibility that similar changes are induced by IUGR.…”

Quality of Life of Preterm Children: Risk and Protective Factors

“…Most studies of prematurity have prioritized assessment of neuropsychomotor and cognitive development, and few have focused on the quality of life of these children (Vieira & Linhares, 2011). The scarcity of studies might be attributed to difficulty precisely defining quality of life and, consequently, methods for assessment.…”

“…Studies of prematurely born children of preschool and school age are even more scarce (Soares et al, 2011;Vieira & Linhares, 2011). One of the first studies in the 1990s found that prematurely born children had worse quality of life than full-term groups; however, their quality of life was also better than had been previously believed.…”

“…A systematic review identified that premature children in preschool and school had worse quality of life indexes than full-term infants (Vieira & Linhares, 2011). However, in adolescents and adults, the effects of prematurity and low birth weight on quality of life decreased with age, and the difference between full-term and premature birth was not maintained; this finding suggests that an adaptation process occurs over time (Hallin & Stjernqvist, 2011).…”

Brain development and scholastic achievement in the Education Quality Measurement System tests in Chilean school-aged children

“…In a review of the literature published in the past 5 y, these studies identified both risk factors (lower birth weight, intraventricular hemorrhage, and low maternal educational level) and protective factors (larger HC, breastfeeding, and higher family income) modulating the development and quality of life of preschool and school-aged children born preterm (10). Small for gestational age at birth and microcephaly at 2 y were independently related to 16-y intelligence quotient (11).…”