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Meta-analysis of the association between preterm delivery and intelligence.
MedLine Citation:
PMID:  21393308     Owner:  NLM     Status:  Publisher    
BACKGROUND: An increasing proportion of infants are born preterm, and their survival has improved. Therefore, their long-term sequelae are of increasing public health importance. METHODS: We conducted a systematic review covering a 30 year period (1980-2009). 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 Egger's 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. RESULTS: 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: 10.47-13.42, 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). CONCLUSIONS: There is a strong and consistent body of evidence suggesting an association between preterm delivery and reduced IQ, with evidence of a dose-response relationship with gestational age.
C O Kerr-Wilson; D F Mackay; G C S Smith; J P Pell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-9
Journal Detail:
Title:  Journal of public health (Oxford, England)     Volume:  -     ISSN:  1741-3850     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101188638     Medline TA:  J Public Health (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Centre for Population Health Sciences, University of Glasgow, Glasgow G12 8RZ, UK.
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