Letter to the editor

Childhood Health and Educational Outcomes After Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis

“…Of the 5865 titles identified from searches, 581 full texts were assessed for eligibility, 15 eligible studies were identified, and six were amenable to meta-analysis (Figure 2). (11,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) This represented 10,907 children with a history of NAS and 1,730,213 unexposed children (Table 5; available at www.jpeds.com). (11,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) Multiple publications from the same cohort were clarified, to avoid duplication of cases in the statistical analysis.…”

“…Studies were retrospective cohort studies (n=8), (11, 29, 35-37, 39, 40, 42) prospective cohort studies (n=1), (33) and case series (n=6). (30-32, 34, 38, 41) Eight studies were deemed to be overall good quality, (11,(32)(33)(34)(35)(36)(37)39) 4 were deemed fair, (29)(30)(31)41) and three poor (Table 6; available at www.jpeds.com). (38,40,42) Included studies were published between 2003-2019 with infants born between 1998 and 2016.…”

“…(38,40,42) Included studies were published between 2003-2019 with infants born between 1998 and 2016. (11,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) The age range of included children was 0-16 years; ages for specific outcome assessments often were not provided (Table 5).…”

“…Four studies reported data relating to speech and language development. (11,29,34,40) Two were deemed sufficiently clinically homogenous for meta-analysis. (11,40) The population age in these two studies was similar, median age 1-4 years and age range 2-4 years in Uebel et al, and Hall et al respectively.…”

“…Seven studies explored visual outcomes after NAS. (11,30,31,33,34,38,40) The age range of included children was 0-13 years (Table 5). (11,30,31,33,37,38,40) Studies consistently demonstrated a high incidence of strabismus and nystagmus after NAS compared with those without previous NAS (Figure 10).…”