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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(02): 186-200
DOI: 10.1055/s-0042-1758866
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Motor and cognitive outcomes of neonates with low birth weight in Brazil: a systematic review and meta-analysis

Desfechos motores e cognitivos de recém-nascidos com baixo peso ao nascer no Brasil: uma revisão sistemática e metanálise
Graciane Radaelli 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Instituto do Cérebro do Rio Grande do Sul, Porto Alegre RS, Brazil.
,
Eduardo Leal-Conceição 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Instituto do Cérebro do Rio Grande do Sul, Porto Alegre RS, Brazil.
,
Felipe Kalil Neto 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Instituto do Cérebro do Rio Grande do Sul, Porto Alegre RS, Brazil.
,
Melissa Rogick Guzzi Taurisano 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Instituto do Cérebro do Rio Grande do Sul, Porto Alegre RS, Brazil.
,
Fernanda Majolo 
2   Universidade do Vale do Taquari, Programa de Pós-Graduação em Biotecnologia, Lajeado RS, Brazil.
,
Fernanda Thays Konat Bruzzo 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Instituto do Cérebro do Rio Grande do Sul, Porto Alegre RS, Brazil.
,
Linda Booij 
3   Concordia University, Faculty of Arts and Science, Department of Psychology, Montreal QC, Canada.
,
Magda Lahorgue Nunes 
4   Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina e InsCer, Disciplina de Neurologia, Porto Alegre RS, Brazil.
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Abstract

Background Data on the outcomes of preterm newborns in South American countries are scarce. Given the great effect of low birth weight (LBW) and/or prematurity on children's neurodevelopment, it is extremely necessary to conduct studies on these phenomena in greater depth in more heterogeneous populations such as those ones from countries with limited resources.

Methods We conducted a comprehensive literature search on databases including PubMed, the Cochrane Library, and Web of Science for articles published in Portuguese and English up to March 2021 involving children born and evaluated in Brazil. The analysis of the risk of bias was adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and used to evaluate the methodology of the included studies.

Results From the eligible trials, 25 articles were selected for qualitative synthesis, and 5 of those, for quantitative synthesis (meta-analysis). The meta-analyses showed that children born with LBW presented lower scores on motor development when compared with controls (standardized mean difference: −1.15; 95% confidence interval [95%CI]: −1.56–−0.73]; I2: 80%) and also scored lower in terms of cognitive development (standardized mean difference: −0.71; 95% CI: −0.99–−0.44; I2: 67%).

Conclusion The results of the present study reinforce that impaired motor and cognitive functions can be a significant long-term outcome of LBW. The lower the gestational age at delivery, the higher the risk of impairment in those domains. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database under number CRD42019112403.

Resumo

Antecedentes Dados sobre desfechos de recém-nascidos prematuros em países da América do Sul são escassos. Dado o grande efeito do baixo peso ao nascer (BPN) e/ou da prematuridade no neurodesenvolvimento das crianças, é extremamente necessária a realização de estudos que investiguem esses fenômenos com maior profundidade em populações mais heterogêneas.

Métodos Realizou-se uma busca da literatura em bases de dados, incluindo PubMed, Cochrane Library e Web of Science, por artigos publicados em português e inglês até março de 2021 envolvendo crianças nascidas e avaliadas no Brasil. A análise de risco de viés foi adaptada da declaração de Fortalecimento do Relato de Estudos Observacionais em Epidemiologia (Strengthening the Reporting of Observational Studies in Epidemiology, STROBE), que foi utilizada para avaliar a metodologia dos estudos.

Resultados Dos estudos elegíveis, 25 artigos foram selecionados para síntese qualitativa, e 5 desses 25, para síntese quantitativa (metanálise). As metanálises mostraram que crianças nascidas com BPN apresentaram pontuação menor em desenvolvimento motor quando comparadas aos controles (diferença média padronizada, −1,15; intervalo de confiança de 95% [IC95%]: −1,56–−0,73]; I2: 80%) e pontuação também menor em termos de desenvolvimento cognitivo (diferença média padronizada, −0,71; IC95%: −0,992−0,44; I2: 67%).

Conclusão Os resultados deste estudo reforçam que o comprometimento das funções motoras e cognitivas pode ser um desfecho significativo de longo prazo do BPN. Quanto menor a idade gestacional no momento do parto, maior o risco de prejuízo nesses domínios. O protocolo do estudo foi registrado no banco de dados International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42019112403.

Keywords

Motor Skills Disorders - Infant, Premature - Systematic Review

Palavras-chave

Transtornos das Habilidades Motoras - Recém-nascido Prematuro - Revisão Sistemática

Authors' Contributions

GR: conception, design, and interpretation of data; drafting the article; and final approval of the version to be published; ELC: analysis and interpretation of data; and final approval of the version to be published; FKN: article draft; and final approval of the version to be published; MRGT, FTKB: acquisition of data; and final approval of the version to be published; FM: interpretation of data; and final approval of the version to be published; LB: analysis of data; and final approval of the version to be published; and MLN: article draft and critical review for important intellectual content; and final approval of the version to be published.




Publication History

Received: 10 June 2021

Accepted: 02 February 2022

Article published online:
02 March 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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