Meta-analysis of the association between preterm delivery and intelligence
Meta-analysis of the association between preterm delivery and intelligence
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DOI：
10.1093/pubmed/fdr024
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发表时间：
2012-06-01
影响因子：
4.4
通讯作者：
Pell, J. P.
中科院分区：
文献类型：
--
作者：
Kerr-Wilson, C. O.;Mackay, D. F.;Pell, J. P.
早产婴儿的比例越来越高，他们的生存率也有所提高。因此，他们的长期后遗症是越来越多的公共卫生importance.We进行了系统的审查，涵盖了30年的时间（1980 - 2009）。一项随机效应荟萃分析提供了早产儿和足月儿个体之间智商得分差异的汇总估计值。使用漏斗图和Eggers检验检查小研究偏倚，并使用荟萃回归研究异质性的可能原因。27项合格的研究涵盖了7044名个体; 3504（50）例早产，3540（50）例足月分娩。他们提供了37种智商差异的估计值。所有早产儿的智商都有所下降，除4人外，其余均达到统计学显著性。总体而言，早产儿的IQ评分低11.94（95 CI：10.47 - 13.42，P 0.001）分。存在中度异质性（总体I-2 74.2，P 0.001），但无显著的小型研究偏倚（P 0.524）。早产和智商之间的关联并没有随着时间的推移而发生显著变化。在整个胎龄范围内存在统计学显著性线性相关性（校正系数：0.91，95 CI：1.64，0.17，P 0.018）。有大量一致的证据表明早产与智商降低之间存在相关性，并有证据表明与胎龄存在剂量反应关系。
An increasing proportion of infants are born preterm, and their survival has improved. Therefore, their long-term sequelae are of increasing public health importance.We conducted a systematic review covering a 30 year period (19802009). A random effects meta-analysis provided a pooled estimate of the difference in IQ score between individuals born preterm and term. Small-study bias was examined using a funnel plot and Eggers test, and meta-regression was used to investigate possible causes of heterogeneity. Cumulative meta-analysis was used to determine if the magnitude of the association had changed over time.The 27 eligible studies covered 7044 individuals; 3504 (50) delivered preterm and 3540 (50) at term. They provided 37 estimates of difference in IQ. All demonstrated a reduced IQ among those delivered preterm and all but four reached statistical significance. Overall, IQ score was 11.94 (95 CI: 10.4713.42, P 0.001) points lower among children born preterm. There was moderate heterogeneity (overall I-2 74.2, P 0.001), but no significant small-study bias (P 0.524). The association between preterm delivery and IQ did not change significantly over time. There was a statistically significant, linear association across the gestational age range (adjusted coefficient: 0.91, 95 CI: 1.64, 0.17, P 0.018).There is a strong and consistent body of evidence suggesting an association between preterm delivery and reduced IQ, with evidence of a doseresponse relationship with gestational age.