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Published on: August 25, 2014
Neurodevelopmental outcome descriptions in cohorts of extremely preterm children
Sharon Ding1,2, Emma J Mew3, Alyssandra Chee-A-Tow3
1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Insights
Reporting of neurodevelopmental outcomes for extremely preterm infants is often incomplete. This impacts clinical decisions and knowledge synthesis for this vulnerable population.
Area of Science:
- Neonatal research
- Pediatric neurology
- Developmental pediatrics
Background:
- Extremely preterm infants (born before 26 weeks' gestation) require comprehensive long-term follow-up.
- Clinical decision-making relies on robust research regarding neurodevelopmental outcomes.
- Completeness of outcome reporting in this field is not well-established.
Purpose of the Study:
- To evaluate the reporting completeness of outcome definitions, selection, measurement, and analysis in cohort studies.
- To assess neurodevelopmental outcome reporting in children born extremely preterm.
- To identify gaps in reporting for cognitive function and cerebral palsy.
Main Methods:
- Systematic review of prospective cohort studies included in a meta-analysis on preterm birth and school-age neurodevelopment.
- Utilized a 55-item checklist to assess outcome reporting (selection, definition, measurement, analysis, presentation, interpretation).
- Calculated reporting frequencies for 'cognitive function' and 'cerebral palsy' outcomes.
Main Results:
- All 14 studies reported 'cognitive function'; 9 reported both 'cognitive function' and 'cerebral palsy'.
- Studies reported only 26-46% of the 55 outcome reporting items (average 33-34%).
- Key omissions included masking of assessors, handling missing data, and stakeholder involvement in outcome selection.
Conclusions:
- Neurodevelopmental outcome reporting in extremely preterm infant studies is variable and incomplete.
- Incomplete reporting hinders interpretation, knowledge synthesis, and evidence-based decision-making.
- Standardized reporting is crucial for reliable long-term follow-up of extremely preterm infants.
Background And Objectives:
Caregivers and clinicians of extremely preterm infants (born before 26 weeks' gestation) depend on long-term follow-up research to inform clinical decision-making. The completeness of outcome reporting in this area is unknown. The objective of this study was to evaluate the reporting of outcome definitions, selection, measurement and analysis in existing cohort studies that report on neurodevelopmental outcomes of children born extremely preterm.
Methods:
We evaluated the completeness of reporting of 'cognitive function' and 'cerebral palsy' in prospective cohort studies summarised in a meta-analysis that assessed the effect of preterm birth on school-age neurodevelopment. Outcome reporting was evaluated using a checklist of 55 items addressing outcome selection, definition, measurement, analysis, presentation and interpretation. Reporting frequencies were calculated to identify strengths and deficiencies in outcome descriptions.
Results:
All 14 included studies reported 'cognitive function' as an outcome; nine reported both 'cognitive function' and 'cerebral palsy' as outcomes. Studies reported between 26% and 46% of the 55 outcome reporting items assessed; results were similar for 'cognitive function' and 'cerebral palsy' (on average 34% and 33% of items reported, respectively). Key methodological concepts often omitted included the reporting of masking of outcome assessors, methods used to handle missing data and stakeholder involvement in outcome selection.
Conclusions:
The reporting of neurodevelopmental outcomes in cohort studies of infants born extremely preterm is variable and often incomplete. This may affect stakeholders' interpretation of study results, impair knowledge synthesis efforts and limit evidence-based decision-making for this population.
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