Long‐term cognition and behavior in children born at early term gestation: A systematic review

Abstract

Introduction Recent recommendations characterize deliveries at 37+0 weeks through 38+6 weeks as early term. We aimed to review the literature systematically on long‐term cognition, school performance and behavior in children born early term (37+0 to 38+6 weeks) compared with full term (39+0 to 40+6 weeks). Material and methods The review was performed according to the PRISMA Statement. The final literature search was performed on 31 January 2019. We located studies in PubMed, Embase, CINAHL and Cochrane Library. Eligible studies were randomized controlled trials, cohort studies and case‐control studies, with outcome assessment performed at 2‐19 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 on year of publication was made. The mean NOS score was 5.8 with a range from 3 to 9. Compared with 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 another 8%‐75% with poorer overall school performance. No meta‐analysis was conducted due to heterogeneity in the outcome measures. Only 10 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 with children born full term.

Higher risk for poor handwriting in Taiwanese children born late preterm

“…Regarding developmental outcomes of children born early term, previous studies have indicated that they have a slightly increased risk of developmental (e.g., language and cognitive problems) and school functional problems (e.g., lower academic achievement) than their peers born at full term [5,7,8]. However, we did not nd such a difference between early term and full term children in terms of their handwriting performance.…”

“…Therefore, more children born late preterm (23.5%) and early term (14.9%) require early intervention programs as compared to their full term born peers (11.9%) [6]. Those children born late preterm and early term births were found to continue to perform poorer than those born full term, including increased needs for special educational support and scored lower in various academic subjects (reading, math, literacy, and writing) compared to their peers born full term [7][8][9][10]. However, school functioning in these children has not been fully investigated.…”

Mental health outcomes of adults born very preterm or with very low birth weight: A systematic review

“…In light of the continued global prevalence, and in conjunction with a now critical mass of preterm born adults who survived following the modern neonatal medicine era (post 1970) [2][3][4], research has begun to unravel the long-term consequences of preterm birth. Facilitated by the maturation of preterm birth study cohorts, the literature now provides significant evidence of developmental adversities across the lifespan [5][6][7][8][9]. However, findings are mixed on whether or not individuals born preterm have increased risk of developmental problems or disorders.…”

Antenatal awareness and obstetric outcomes in large fetuses: A retrospective evaluation

“…There were no instances of BPBP out of 407 cases randomized to induction at 37-38 weeks. Nevertheless, long term cognitive outcomes which peak later, such as school achievement at 16 years of age or attention deficits have to be taken into account with early term delivery [23,24].…”