Current pediatric reviews · 2026
Motor, Cognitive, and Language Development in Preterm Infants: A Systematic Review with Meta-analysis.
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Fernandes Sany, Valentini Nadia C, Andreis Lucia, Sonza Anelise, Germano Andresa M C, Rosa Neto Francisco
Аннотация
INTRODUCTION/OBJECTIVE: Preterm birth is associated with an increased risk of early neurodevelopmental difficulties, but reported prevalence varies widely across studies and across degrees of prematurity. This review aimed to estimate the prevalence of motor, language, and cognitive delays in preterm infants according to the degree of prematurity.
METHODS: This review followed the PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021252388). PubMed, VHL, SciELO, Scopus, and Embase were searched for cohort and cross-sectional studies published from January 2012 to February 2023 in English, Portuguese, or Spanish. Eligible studies evaluated preterm infants from birth to 24 months of corrected age using the Bayley Scales of Infant and Toddler Development (BSID/BSITD), the Brunet-Lézine Scale, or the Denver Developmental Screening Test. Randomeffects proportional meta-analyses using the Freeman-Tukey double-arcsine transformation were conducted to estimate the prevalence of mild and significant motor, language, and cognitive delays.
RESULTS: Twenty-two studies were included, and pooled analyses included 2,958-3,258 infants, depending on the outcome. The Bayley Scales were used in all included studies, whereas the Brunet- Lezine and Denver instruments were each reported in one study in combination with the Bayley. The pooled prevalence of mild delays was highest for language (22.73%; 95% CI: 13.92-32.93), followed by motor (18.15%; 95% CI: 10.72-26.91) and cognitive (11.90%; 95% CI: 5.80-19.71) domains. Significant delays were less frequent overall. Extremely preterm infants showed the highest prevalence across domains, especially for mild motor and language delays.
DISCUSSION: Considerable heterogeneity was observed across analyses, likely reflecting differences in assessment age, Bayley edition, clinical profiles, and study settings. Therefore, pooled estimates should be interpreted with caution.
CONCLUSION: Preterm infants, particularly those born extremely preterm, present a substantial prevalence of neurodevelopmental delays during the first two years of life. These findings support early developmental surveillance, timely referral, and targeted intervention in this high-risk paediatric population.
METHODS: This review followed the PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021252388). PubMed, VHL, SciELO, Scopus, and Embase were searched for cohort and cross-sectional studies published from January 2012 to February 2023 in English, Portuguese, or Spanish. Eligible studies evaluated preterm infants from birth to 24 months of corrected age using the Bayley Scales of Infant and Toddler Development (BSID/BSITD), the Brunet-Lézine Scale, or the Denver Developmental Screening Test. Randomeffects proportional meta-analyses using the Freeman-Tukey double-arcsine transformation were conducted to estimate the prevalence of mild and significant motor, language, and cognitive delays.
RESULTS: Twenty-two studies were included, and pooled analyses included 2,958-3,258 infants, depending on the outcome. The Bayley Scales were used in all included studies, whereas the Brunet- Lezine and Denver instruments were each reported in one study in combination with the Bayley. The pooled prevalence of mild delays was highest for language (22.73%; 95% CI: 13.92-32.93), followed by motor (18.15%; 95% CI: 10.72-26.91) and cognitive (11.90%; 95% CI: 5.80-19.71) domains. Significant delays were less frequent overall. Extremely preterm infants showed the highest prevalence across domains, especially for mild motor and language delays.
DISCUSSION: Considerable heterogeneity was observed across analyses, likely reflecting differences in assessment age, Bayley edition, clinical profiles, and study settings. Therefore, pooled estimates should be interpreted with caution.
CONCLUSION: Preterm infants, particularly those born extremely preterm, present a substantial prevalence of neurodevelopmental delays during the first two years of life. These findings support early developmental surveillance, timely referral, and targeted intervention in this high-risk paediatric population.