Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review.

Full Abstract

AIM: The aim of this study was to review the effects of early developmental intervention after discharge from hospital on motor and cognitive development in preterm infants. METHOD: Randomized controlled trials (RCTs) or quasi-RCTs of early developmental intervention programmes for preterm infants in which motor or cognitive outcomes were reported and in which the intervention commenced before or after discharge were included. A systematic review and meta-analysis of studies grouped by intervention, age of outcome, and study quality was undertaken. Databases searched (up to January 2009) included the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, PsycINFO, and Embase. RESULTS: Eighteen studies met the inclusion criteria (2686 patients randomized), but only 11 studies had data suitable for meta-analysis. Early developmental intervention improved cognitive outcomes at infant age (developmental quotient: standardized mean difference [SMD] 0.42, 95% confidence interval [CI] 0.33-0.52; p<0.001), and at preschool age (IQ: SMD 0.46, 95% CI 0.33-0.59; p<0.001). However, the benefit was not sustained at school age (IQ: SMD 0.02, 95% CI -0.10 to 0.14; p=0.71). Early intervention had little effect on motor outcome at infant or school age, and there was no study reporting motor outcome at preschool age. INTERPRETATION: Current evidence suggests that the benefits of developmental intervention postdischarge are restricted to short-term gains in cognitive outcome.

Author information

Author/s: Orton, Jane (J); Spittle, Alicia (A); Doyle, Lex (L); Anderson, Peter (P); Boyd, Roslyn (R);

Affiliation: The Royal Women's Hospital, Melbourne, Australia. jane.orton(-atsign-)thewomens.org.au

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: Developmental medicine and child neurology (Dev Med Child Neurol), published in England. (Language: eng)

Reference: 2009-Nov; vol 51 (issue 11) : pp 851-9

Dates: Created 2009/10/02; Completed 2009/10/22;

PMID: 19732117, status: MEDLINE (last retrieval date: 10/22/2009, IMS Date: )

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