ACKNOWLEDGEMENTS Public Health (Dora Lush) NHMRC Postgraduate fellowship (AS); NHMRC Postdoctoral Training Fellowship (PA), NHMRC Career Development Fellowship Project Grant (RB): National Health and Medical Research Council (NHMRC) 284512. A previous version has been published in The Cochrane Library, Issue 2, April 2007.
Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review
Article first published online: 1 SEP 2009
© The Authors. Journal compilation © Mac Keith Press 2009
Developmental Medicine & Child Neurology
Volume 51, Issue 11, pages 851–859, November 2009
How to Cite
ORTON, J., SPITTLE, A., DOYLE, L., ANDERSON, P. and BOYD, R. (2009), Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review. Developmental Medicine & Child Neurology, 51: 851–859. doi: 10.1111/j.1469-8749.2009.03414.x
- Issue published online: 1 OCT 2009
- Article first published online: 1 SEP 2009
- PUBLICATION DATA Accepted for publication 1st June 2009. Published online 1st September 2009.
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.