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Published on: August 25, 2014
Attentional Deficits Following Preterm Birth: A Systematic Review and Meta-Analysis
Kathrin Kollndorfer1, Darlene Alicia Hörle1, Florian Ph S Fischmeister1
1Developmental and Interventional Neuroimaging Lab (DINLAB), Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria.
Insights
Children born preterm exhibit significant attention deficits, impacting both sustained and selective attention. These impairments are more severe in extremely preterm infants, highlighting the need for targeted early interventions.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Preterm birth is linked to neurodevelopmental issues, including attention problems.
- Existing evidence on attention in school-aged preterm children requires synthesis.
- Understanding attentional deficits is crucial for early intervention strategies.
Purpose of the Study:
- To systematically review and meta-analyze evidence on sustained and selective attention in school-aged preterm children.
- To quantify attention deficits associated with preterm birth.
- To explore the impact of gestational age on attention outcomes.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Literature search across major databases (PubMed, MEDLINE, EMBASE, Web of Science).
- Inclusion of 15 studies for sustained attention and 12 for selective attention in children aged 5-12 years.
Main Results:
- Preterm children demonstrated significantly poorer sustained attention (Hedges' g = -0.31) and selective attention (Hedges' g = -0.27) compared to term-born controls.
- Sustained attention deficits were observed across all gestational age subgroups.
- Selective attention deficits were more pronounced in very early and extremely early preterm infants (born before 32 weeks).
Conclusions:
- Preterm birth is associated with persistent deficits in sustained and selective attention.
- Children born before 32 weeks gestation are particularly vulnerable to attention impairments.
- Early monitoring and tailored interventions are essential for supporting attentional development in preterm populations.
Abstract:
Objective: Preterm birth has been associated with an elevated risk of a broad range of neurodevelopmental impairments, including attentional deficits. This systematic review and meta-analysis aimed to synthesize the existing evidence on sustained and selective attention in school-aged children born preterm. Methods: Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Ovid MEDLINE, EMBASE, and Web of Science. Eligible studies included assessments of sustained and/or selective attention in children aged 5-12 years born before 37 weeks of gestation. Data from 15 studies (sustained attention) and 12 studies (selective attention) were analyzed using random-effects meta-analyses. Additionally, subgroup analyses were performed based on gestational age. Results: Preterm-born children showed significantly poorer performance in sustained (Hedges' g = -0.31, p < 0.001) and selective attention (Hedges' g = -0.27, p < 0.001) compared to term-born controls. While sustained attention deficits were consistent across all gestational age subgroups, selective attention deficits were more pronounced in very early and extremely early preterm-born children. Moderate to late preterm-born children showed less impairment in selective attention tasks. Conclusions: Preterm birth is associated with measurable and persistent deficits in both sustained and selective attention, with greater vulnerability in children born before 32 weeks of gestation. These findings underscore the importance of implementing early monitoring and intervention strategies specifically designed to support attentional development in this high-risk population.
