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Preterm Brain Injury and Neurodevelopmental Outcomes: A Meta-analysis
Philippa Rees1, Caitriona Callan2, Karan R Chadda3
1Population Policy and Practice, Great Ormond Street UCL Institute of Child Health, London, United Kingdon.
Pediatrics
|November 4, 2022
Summary
Preterm infants with intraventricular hemorrhage (IVH) or white matter injury (WMI) face increased risks of neurodevelopmental impairment. Early identification and intervention are crucial for improving outcomes in these vulnerable infants.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Neuroscience
Background:
- Preterm brain injuries, including intraventricular hemorrhage (IVH) and white matter injury (WMI), are significant concerns in neonatal care.
- Neurodevelopmental outcomes for preterm infants are continually evolving with advancements in neonatal care.
Approach:
- A systematic review and meta-analysis were conducted to evaluate neurodevelopmental outcomes in preterm infants with IVH or WMI.
- Literature searches across 10 databases (2000-2021) identified observational studies reporting 3-year neurodevelopmental outcomes.
Key Points:
- Increased risks of moderate-severe neurodevelopmental impairment were observed with IVH grades 1-2 (aOR 1.35) and 3-4 (aOR 4.26).
- Children with IVH experienced higher risks of cerebral palsy, cognitive, hearing, and visual impairments.
- White matter injury (WMI) was associated with substantially higher risks of cerebral palsy, motor, and cognitive impairments.
Conclusions:
- Mild IVH, severe IVH, and WMI are linked to adverse neurodevelopmental outcomes in preterm infants.
- Standardized core outcome sets and open-access data are needed to better understand these complex outcomes.
