Effects of interdisciplinary early developmental intervention programs on behavior, executive functioning and...

To systematically evaluate evidence on the effects of post-discharge early developmental intervention programs (EI) on behavioral development, quality of life, participation, executive functioning, parent-child interaction, and use of medical services from infancy through adolescence in children born preterm.

Four bibliographic databases and one trial registry were systematically searched for randomized controlled trials up to April 23, 2024. Two reviewers independently screened studies and extracted data. In clinically and methodologically comparable studies, random-effects meta-analysis was performed. Risk of bias was assessed with the Cochrane RoB 2 tool, and certainty of evidence with the GRADE approach.

Twenty-six studies met inclusion criteria, eleven studies including 2315 preterm born infants reported relevant outcomes, and seven contributed to meta-analyses. Most reported results showed some concerns or high risk of bias; certainty of evidence ranged from very low to moderate across outcomes. EI probably has little to no effect on special educational needs (moderate-certainty). EI may slightly increase maternal sensitivity and may slightly reduce behavioral problems in infancy (low-certainty). There is very low-certainty evidence on attention, language skills, executive functioning, and use of medical services. No studies evaluated the effect on ADHD, quality of life, or participation related to mobility or leisure activities.

EI may improve some outcomes in preterm children, but evidence for most outcomes remains uncertain. High-quality, contemporary trials are needed to establish reliable clinical recommendations regarding EI strategies and complementary interventions throughout childhood.