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

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Developmental Psychology

Background:

• Recent recommendations define early term deliveries as occurring between 37 weeks 0 days and 38 weeks 6 days.
• Children born at early term may experience different long-term outcomes compared to those born at full term.

Purpose of the Study:

• To systematically review existing literature on the long-term cognitive function, academic performance, and behavioral outcomes of children born early term.
• To compare these outcomes in early term infants with those born at full term (39 weeks 0 days to 40 weeks 6 days).

Main Methods:

• A systematic literature search was conducted in PubMed, Embase, CINAHL, and Cochrane Library up to January 31, 2019.
• Included studies were randomized controlled trials, cohort studies, and case-control studies with outcomes assessed between 2 and 19 years of age.
• Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), with a mean score of 5.8.

Main Results:

• The review included 42 observational studies published between 2006 and 2018.
• Children born early term showed lower intelligence scores in early adulthood and an increased risk (up to 30%) of attention-deficit/hyperactivity disorder (ADHD).
• Increased risks were also observed for cognitive problems (10%-40%), language impairments (25%), and poorer school performance (8%-75%) compared to full-term infants.

Conclusions:

• Infants born at early term are at a significantly increased risk for cognitive deficits.
• Early term birth is associated with poorer academic achievement and a higher prevalence of behavioral problems.
• These findings underscore the importance of considering potential long-term developmental impacts of early term deliveries.