Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children
Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (
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creator | Aarnoudse-Moens, Cornelieke Sandrine Hanan Weisglas-Kuperus, Nynke van Goudoever, Johannes Bernard Oosterlaan, Jaap |
description | Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm ( |
doi_str_mv | 10.1542/peds.2008-2816 |
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Suitable for inclusion were 14 studies on academic achievement, 9 studies on behavioral problems, and 12 studies on EF, which compared a total of 4125 very preterm and/or VLBW children with 3197 term-born controls. Combined effect sizes for the 3 outcome domains were calculated in terms of Cohen's d. Q-test statistics were performed to test homogeneity among the obtained effect sizes. Pearson's correlation coefficients were calculated to examine the impact of mean birth weight and mean gestational age, as well as the influence of mean age at assessment on the effect sizes for academic achievement, behavioral problems, and EF.
Combined effect sizes show that very preterm and/or VLBW children score 0.60 SD lower on mathematics tests, 0.48 SD on reading tests, and 0.76 SD on spelling tests than term-born peers. Of all behavioral problems stacked, attention problems were most pronounced in very preterm and/or VLBW children, with teacher and parent ratings being 0.43 to 0.59 SD higher than for controls, respectively. Combined effect sizes for parent and teacher ratings of internalizing behavior problems were small (<0.28) and for externalizing behavior problems negligible (<0.09) and not significant. Combined effect sizes for EF revealed a decrement of 0.57 SD for verbal fluency, 0.36 SD for working memory, and 0.49 SD for cognitive flexibility in comparison to controls. Mean age at assessment was not correlated with the strength of the effect sizes. Mathematics and reading performance, parent ratings of internalizing problems, teacher ratings of externalizing behavior, and attention problems, showed strong and positive correlations with mean birth weight and mean gestational age (all r values > 0.51).
Very preterm and/or VLBW children have moderate-to-severe deficits in academic achievement, attention problems, and internalizing behavioral problems and poor EF, which are adverse outcomes that were strongly correlated to their immaturity at birth. During transition to young adulthood these children continue to lag behind term-born peers.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2008-2816</identifier><identifier>PMID: 19651588</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>Elk Grove Village, IL: Am Acad Pediatrics</publisher><subject>Academic achievement ; Academic underachievement ; Achievement ; Adolescent ; Attention Deficit Disorder with Hyperactivity - diagnosis ; Attention Deficit Disorder with Hyperactivity - epidemiology ; Biological and medical sciences ; Birth weight ; Birth weight, Low ; Brain Damage, Chronic - diagnosis ; Brain Damage, Chronic - epidemiology ; Child ; Child Behavior Disorders - diagnosis ; Child Behavior Disorders - epidemiology ; Child psychopathology ; Child, Preschool ; Childhood mental disorders ; Children & youth ; Cognition Disorders - diagnosis ; Cognition Disorders - epidemiology ; Cross-Sectional Studies ; Demographic aspects ; Developmental Disabilities - diagnosis ; Developmental Disabilities - epidemiology ; Diseases of mother, fetus and pregnancy ; Executive function (Psychology) ; General aspects ; Gestational Age ; Gynecology. Andrology. Obstetrics ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature, Diseases - diagnosis ; Infant, Premature, Diseases - epidemiology ; Infant, Very Low Birth Weight ; Internal-External Control ; Learning Disorders - diagnosis ; Learning Disorders - epidemiology ; Longitudinal Studies ; Low birth weight ; Medical sciences ; Meta-analysis ; Miscellaneous ; Neurologic Examination - statistics & numerical data ; Neuropsychological Tests - statistics & numerical data ; Patient outcomes ; Pediatrics ; Pregnancy. Fetus. Placenta ; Psychometrics - statistics & numerical data ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Reference Values ; Risk Factors ; Statistics as Topic</subject><ispartof>Pediatrics (Evanston), 2009-08, Vol.124 (2), p.717-728</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright American Academy of Pediatrics Aug 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c533t-2332dd4ed4b1f2118ed695ac4b61b906afb7688e776915ad2f2343a86dfa6873</citedby><cites>FETCH-LOGICAL-c533t-2332dd4ed4b1f2118ed695ac4b61b906afb7688e776915ad2f2343a86dfa6873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21809821$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19651588$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aarnoudse-Moens, Cornelieke Sandrine Hanan</creatorcontrib><creatorcontrib>Weisglas-Kuperus, Nynke</creatorcontrib><creatorcontrib>van Goudoever, Johannes Bernard</creatorcontrib><creatorcontrib>Oosterlaan, Jaap</creatorcontrib><title>Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (<or=33 weeks' gestation) and/or very low birth weight (VLBW) (<or=1500 g) children. Great variability in the published results, however, hinders the field in studying underlying dysfunctions and developing intervention strategies. We conducted a quantitative meta-analysis of studies published between 1998 and 2008 on academic achievement, behavioral functioning, and EF with the aim of providing aggregated measures of effect size for these outcome domains.
Suitable for inclusion were 14 studies on academic achievement, 9 studies on behavioral problems, and 12 studies on EF, which compared a total of 4125 very preterm and/or VLBW children with 3197 term-born controls. Combined effect sizes for the 3 outcome domains were calculated in terms of Cohen's d. Q-test statistics were performed to test homogeneity among the obtained effect sizes. Pearson's correlation coefficients were calculated to examine the impact of mean birth weight and mean gestational age, as well as the influence of mean age at assessment on the effect sizes for academic achievement, behavioral problems, and EF.
Combined effect sizes show that very preterm and/or VLBW children score 0.60 SD lower on mathematics tests, 0.48 SD on reading tests, and 0.76 SD on spelling tests than term-born peers. Of all behavioral problems stacked, attention problems were most pronounced in very preterm and/or VLBW children, with teacher and parent ratings being 0.43 to 0.59 SD higher than for controls, respectively. Combined effect sizes for parent and teacher ratings of internalizing behavior problems were small (<0.28) and for externalizing behavior problems negligible (<0.09) and not significant. Combined effect sizes for EF revealed a decrement of 0.57 SD for verbal fluency, 0.36 SD for working memory, and 0.49 SD for cognitive flexibility in comparison to controls. Mean age at assessment was not correlated with the strength of the effect sizes. Mathematics and reading performance, parent ratings of internalizing problems, teacher ratings of externalizing behavior, and attention problems, showed strong and positive correlations with mean birth weight and mean gestational age (all r values > 0.51).
Very preterm and/or VLBW children have moderate-to-severe deficits in academic achievement, attention problems, and internalizing behavioral problems and poor EF, which are adverse outcomes that were strongly correlated to their immaturity at birth. During transition to young adulthood these children continue to lag behind term-born peers.</description><subject>Academic achievement</subject><subject>Academic underachievement</subject><subject>Achievement</subject><subject>Adolescent</subject><subject>Attention Deficit Disorder with Hyperactivity - diagnosis</subject><subject>Attention Deficit Disorder with Hyperactivity - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Birth weight</subject><subject>Birth weight, Low</subject><subject>Brain Damage, Chronic - diagnosis</subject><subject>Brain Damage, Chronic - epidemiology</subject><subject>Child</subject><subject>Child Behavior Disorders - diagnosis</subject><subject>Child Behavior Disorders - epidemiology</subject><subject>Child psychopathology</subject><subject>Child, Preschool</subject><subject>Childhood mental disorders</subject><subject>Children & youth</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Demographic aspects</subject><subject>Developmental Disabilities - diagnosis</subject><subject>Developmental Disabilities - epidemiology</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Executive function (Psychology)</subject><subject>General aspects</subject><subject>Gestational Age</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Extremely Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Infant, Premature, Diseases - diagnosis</subject><subject>Infant, Premature, Diseases - epidemiology</subject><subject>Infant, Very Low Birth Weight</subject><subject>Internal-External Control</subject><subject>Learning Disorders - diagnosis</subject><subject>Learning Disorders - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Low birth weight</subject><subject>Medical sciences</subject><subject>Meta-analysis</subject><subject>Miscellaneous</subject><subject>Neurologic Examination - statistics & numerical data</subject><subject>Neuropsychological Tests - statistics & numerical data</subject><subject>Patient outcomes</subject><subject>Pediatrics</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Psychometrics - statistics & numerical data</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Reference Values</subject><subject>Risk Factors</subject><subject>Statistics as Topic</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0U2P0zAQBuAIgdiycOWILCS4pevvOMdS8SUVymEFR8uJJ41XTlzshKX_HketWMTJlvXYM563KF4SvCaC05sj2LSmGKuSKiIfFSuCa1VyWonHxQpjRkqOsbgqnqV0hzHmoqJPiytSS0GEUqtCf4HJlJvR-FNyCYUOfYU5hgZ688uFaDzaz1MbBkjIjeg7xBP6FmGCOCAz2psQz2e7cI_euTj16Ae4Qz-hbe-8jTA-L550xid4cVmvi9sP72-3n8rd_uPn7WZXtoKxqaSMUWs5WN6QjhKiwMpamJY3kjQ1lqZrKqkUVJWsiTCWdpRxZpS0nZGqYtfF2_Ozxxh-zpAmPbjUgvdmhDAnLSshKFM8w9f_wbswx_z9pClVWVRYZlSe0cF40G5swzjB7zwG7-EAOje-3esNpTVXnGCR_frs2xhSitDpY3SDiSdNsF5i0ktMeolJLzHlC68uXczNAPaBX3LJ4M0FmNQa30Uzti79dZSoHDMlD5X7PPV7F2Gp5MwUXZv-2RLKNdUVqdgfOwup3w</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Aarnoudse-Moens, Cornelieke Sandrine Hanan</creator><creator>Weisglas-Kuperus, Nynke</creator><creator>van Goudoever, Johannes Bernard</creator><creator>Oosterlaan, Jaap</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children</title><author>Aarnoudse-Moens, Cornelieke Sandrine Hanan ; Weisglas-Kuperus, Nynke ; van Goudoever, Johannes Bernard ; Oosterlaan, Jaap</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c533t-2332dd4ed4b1f2118ed695ac4b61b906afb7688e776915ad2f2343a86dfa6873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Academic achievement</topic><topic>Academic underachievement</topic><topic>Achievement</topic><topic>Adolescent</topic><topic>Attention Deficit Disorder with Hyperactivity - diagnosis</topic><topic>Attention Deficit Disorder with Hyperactivity - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Birth weight</topic><topic>Birth weight, Low</topic><topic>Brain Damage, Chronic - diagnosis</topic><topic>Brain Damage, Chronic - epidemiology</topic><topic>Child</topic><topic>Child Behavior Disorders - diagnosis</topic><topic>Child Behavior Disorders - epidemiology</topic><topic>Child psychopathology</topic><topic>Child, Preschool</topic><topic>Childhood mental disorders</topic><topic>Children & youth</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Demographic aspects</topic><topic>Developmental Disabilities - diagnosis</topic><topic>Developmental Disabilities - epidemiology</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Executive function (Psychology)</topic><topic>General aspects</topic><topic>Gestational Age</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Extremely Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Infant, Premature, Diseases - diagnosis</topic><topic>Infant, Premature, Diseases - epidemiology</topic><topic>Infant, Very Low Birth Weight</topic><topic>Internal-External Control</topic><topic>Learning Disorders - diagnosis</topic><topic>Learning Disorders - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Low birth weight</topic><topic>Medical sciences</topic><topic>Meta-analysis</topic><topic>Miscellaneous</topic><topic>Neurologic Examination - statistics & numerical data</topic><topic>Neuropsychological Tests - statistics & numerical data</topic><topic>Patient outcomes</topic><topic>Pediatrics</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Psychometrics - statistics & numerical data</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Reference Values</topic><topic>Risk Factors</topic><topic>Statistics as Topic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aarnoudse-Moens, Cornelieke Sandrine Hanan</creatorcontrib><creatorcontrib>Weisglas-Kuperus, Nynke</creatorcontrib><creatorcontrib>van Goudoever, Johannes Bernard</creatorcontrib><creatorcontrib>Oosterlaan, Jaap</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aarnoudse-Moens, Cornelieke Sandrine Hanan</au><au>Weisglas-Kuperus, Nynke</au><au>van Goudoever, Johannes Bernard</au><au>Oosterlaan, Jaap</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>124</volume><issue>2</issue><spage>717</spage><epage>728</epage><pages>717-728</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (<or=33 weeks' gestation) and/or very low birth weight (VLBW) (<or=1500 g) children. Great variability in the published results, however, hinders the field in studying underlying dysfunctions and developing intervention strategies. We conducted a quantitative meta-analysis of studies published between 1998 and 2008 on academic achievement, behavioral functioning, and EF with the aim of providing aggregated measures of effect size for these outcome domains.
Suitable for inclusion were 14 studies on academic achievement, 9 studies on behavioral problems, and 12 studies on EF, which compared a total of 4125 very preterm and/or VLBW children with 3197 term-born controls. Combined effect sizes for the 3 outcome domains were calculated in terms of Cohen's d. Q-test statistics were performed to test homogeneity among the obtained effect sizes. Pearson's correlation coefficients were calculated to examine the impact of mean birth weight and mean gestational age, as well as the influence of mean age at assessment on the effect sizes for academic achievement, behavioral problems, and EF.
Combined effect sizes show that very preterm and/or VLBW children score 0.60 SD lower on mathematics tests, 0.48 SD on reading tests, and 0.76 SD on spelling tests than term-born peers. Of all behavioral problems stacked, attention problems were most pronounced in very preterm and/or VLBW children, with teacher and parent ratings being 0.43 to 0.59 SD higher than for controls, respectively. Combined effect sizes for parent and teacher ratings of internalizing behavior problems were small (<0.28) and for externalizing behavior problems negligible (<0.09) and not significant. Combined effect sizes for EF revealed a decrement of 0.57 SD for verbal fluency, 0.36 SD for working memory, and 0.49 SD for cognitive flexibility in comparison to controls. Mean age at assessment was not correlated with the strength of the effect sizes. Mathematics and reading performance, parent ratings of internalizing problems, teacher ratings of externalizing behavior, and attention problems, showed strong and positive correlations with mean birth weight and mean gestational age (all r values > 0.51).
Very preterm and/or VLBW children have moderate-to-severe deficits in academic achievement, attention problems, and internalizing behavioral problems and poor EF, which are adverse outcomes that were strongly correlated to their immaturity at birth. During transition to young adulthood these children continue to lag behind term-born peers.</abstract><cop>Elk Grove Village, IL</cop><pub>Am Acad Pediatrics</pub><pmid>19651588</pmid><doi>10.1542/peds.2008-2816</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Academic achievement Academic underachievement Achievement Adolescent Attention Deficit Disorder with Hyperactivity - diagnosis Attention Deficit Disorder with Hyperactivity - epidemiology Biological and medical sciences Birth weight Birth weight, Low Brain Damage, Chronic - diagnosis Brain Damage, Chronic - epidemiology Child Child Behavior Disorders - diagnosis Child Behavior Disorders - epidemiology Child psychopathology Child, Preschool Childhood mental disorders Children & youth Cognition Disorders - diagnosis Cognition Disorders - epidemiology Cross-Sectional Studies Demographic aspects Developmental Disabilities - diagnosis Developmental Disabilities - epidemiology Diseases of mother, fetus and pregnancy Executive function (Psychology) General aspects Gestational Age Gynecology. Andrology. Obstetrics Humans Infant Infant, Extremely Low Birth Weight Infant, Newborn Infant, Premature, Diseases - diagnosis Infant, Premature, Diseases - epidemiology Infant, Very Low Birth Weight Internal-External Control Learning Disorders - diagnosis Learning Disorders - epidemiology Longitudinal Studies Low birth weight Medical sciences Meta-analysis Miscellaneous Neurologic Examination - statistics & numerical data Neuropsychological Tests - statistics & numerical data Patient outcomes Pediatrics Pregnancy. Fetus. Placenta Psychometrics - statistics & numerical data Public health. Hygiene Public health. Hygiene-occupational medicine Reference Values Risk Factors Statistics as Topic |
title | Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children |
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