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

Jane Orton, Alicia Spittle, Lex Doyle, Peter Anderson, Roslyn Boyd

Research output: Contribution to journalReview ArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)851-859
Number of pages9
JournalDevelopmental Medicine and Child Neurology
Volume51
Issue number11
DOIs
Publication statusPublished - 2009

Cite this

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title = "Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review",
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.",
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Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review. / Orton, Jane; Spittle, Alicia; Doyle, Lex; Anderson, Peter; Boyd, Roslyn.

In: Developmental Medicine and Child Neurology, Vol. 51, No. 11, 2009, p. 851-859.

Research output: Contribution to journalReview ArticleResearchpeer-review

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T1 - Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review

AU - Orton, Jane

AU - Spittle, Alicia

AU - Doyle, Lex

AU - Anderson, Peter

AU - Boyd, Roslyn

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N2 - 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.

AB - 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.

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