Multidisciplinary and neuroimaging findings in preterm born very low birthweight individuals from birth to 28 years of age: A systematic review of a Norwegian prospective cohort study

Abstract

Background Children born preterm with very low birthweight (VLBW) face long‐lasting neurodevelopmental challenges, where multidisciplinary assessments are warranted. The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding and conceptualising these outcomes. Objectives We aimed to review clinical and neuroimaging findings from birth to adulthood in a Norwegian cohort of individuals born preterm with VLBW (gestational age <37 weeks, birthweight ≤1500 g) within the framework of ICF. Data Sources We searched PubMed and Embase for articles reporting results of the Norwegian University of Science and Technology (NTNU) Low Birth Weight in a Lifetime Perspective study. Study Selection and Data Extraction We included original articles reporting proportions of adverse outcomes, mean group differences, risk factors or associations between outcomes. Data were extracted according to ICF's two‐level classification. Body functions and structures comprised outcomes of brain structures, cognition, mental health, vision, pain and physical health. Activities and participation comprised motor skills, general and social functioning, education, employment, and health‐related quality of life. Synthesis We performed a qualitative synthesis of included articles. Where mean (SD) was reported, we calculated group differences in SD units. Results Fifty‐eight publications were included. Within body functions and structures, increased prevalence of brain structure pathology, lower cognitive performance, mental health problems, visual and physical health impairments through childhood, adolescence and young adulthood were reported among preterm VLBW participants compared with controls. Within activities and participation, motor problems, lower general and social functioning, and lower academic attainment were found. Perinatal factors were associated with several outcomes, and longitudinal findings suggested persistent consequences of being born preterm with VLBW. Conclusions Being born preterm with VLBW has long‐term influences on body functions and structures, activities and participation. The ICF is appropriate for assessing general domains of functioning and guiding the management of individuals born preterm with VLBW.

Health-Related Quality-of-Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence From an Individual Participant Data Meta-Analysis

“…The one-stage IPD analysis could be implemented either using a fixed-effects or random-effects model. [61] In our study, cohort study participants were enrolled across different geographical regions, ages and time frames, which suggests the presence of systematic differences across Additional details for each study can be found in published research as follows: BLS [46], VICS [47], NTNU LBW Life [50], EPICure [48] and NZ-VLBW [ 1). Study participants also shared common characteristics that were fixed across geographic and socioeconomic dimensions caused by study-specific or countryspecific factors.…”

Prognosis after very preterm birth: Insights for the future

“…For example, in adolescence and adulthood, very preterm survivors continue to perform below term peers across a range of cognitive domains [2][3][4] which is likely related to altered cerebral maturation and white matter microstructure. 3 Regarding health status, older survivors tend to be less active, have poorer motor skills and cardiorespiratory fitness, lower bone density and higher systolic blood pressure and insulin resistance. 3,5 These findings are concerning and highlight the need to study the health of very preterm survivors into middle age and beyond.…”

“…Papers in this special issue demonstrate that the developmental and health issues observed in early childhood are likely to reflect persistent life‐long concerns. For example, in adolescence and adulthood, very preterm survivors continue to perform below term peers across a range of cognitive domains 2–4 which is likely related to altered cerebral maturation and white matter microstructure 3 . Regarding health status, older survivors tend to be less active, have poorer motor skills and cardiorespiratory fitness, lower bone density and higher systolic blood pressure and insulin resistance 3,5 .…”

“…One approach is applying a framework that assesses functioning from a multi‐dimensional perspective (e.g. International Classification of Functioning, Disability and Health, ICF), as proposed by Evensen et al 3 Related to the broad functional consequences in very preterm survivors is the associated economic cost. The paper by Achana et al 6 provides a utility and cost framework to capture the excess economic costs associated with health and developmental consequences of very preterm birth for families and societies.…”

“…3 Regarding health status, older survivors tend to be less active, have poorer motor skills and cardiorespiratory fitness, lower bone density and higher systolic blood pressure and insulin resistance. 3,5 These findings are concerning and highlight the need to study the health of very preterm survivors into middle age and beyond.…”