Women and Children's Health, King's College London, London, UK.
Edith Cowan University, Joondalup, Western Australia, Australia.
Arch Dis Child. 2023 Apr;108(4):247-257. doi: 10.1136/archdischild-2022-324506. Epub 2023 Feb 2.
To determine the effect of early childhood development interventions delivered by healthcare providers (HCP-ECD) on child cognition and maternal mental health.
Systematic review, meta-analysis.
Healthcare setting or home.
Infants under 1 month of age.
HCP-ECD interventions that supported responsive caregiving, early learning and motor stimulation. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews were searched until 15 November 2021. Studies reporting prespecified outcomes were pooled using standard meta-analytical methods.
Cognitive development in children at 0-36 months.
Forty-two randomised controlled trials with 15 557 infants were included in the narrative synthesis. Twenty-seven trials were included in the meta-analyses. Pooled data from 13 trials suggest that HCP-ECD interventions may improve cognitive outcomes in children between 0 and 36 months (Bayley Scales of Infant Development version IIII (BSID-III) mean difference (MD) 2.65; 95% CI 0.61 to 4.70; 2482 participants; low certainty of evidence). Pooled data from nine trials suggest improvements in motor development (BSID-III MD 4.01; 95% CI 1.54 to 6.48; 1437 participants; low certainty of evidence). There was no evidence of improvement in maternal mental health (standardised MD -0.13; 95% CI -0.28 to 0.03; 2806 participants; 11 trials; low certainty of evidence).
We report promising evidence, particularly for cognitive and motor outcomes, of the effect of HCP-ECD interventions. However, effect sizes were small, and the certainty of evidence ranged from very low to moderate. Additional high-quality research is required.
CRD42019122021.
确定医疗保健提供者（HCP-ECD）提供的早期儿童发展干预措施对儿童认知和产妇心理健康的影响。
系统评价，荟萃分析。
医疗保健环境或家庭。
1 个月以下的婴儿。
支持响应式照护、早期学习和运动刺激的 HCP-ECD 干预措施。直到 2021 年 11 月 15 日，检索了 MEDLINE、EMBASE、Cochrane 对照试验中心注册库、卫生技术评估数据库、效果摘要数据库和 Cochrane 系统评价数据库。使用标准荟萃分析方法对报告预定义结局的研究进行了汇总。
0-36 个月儿童的认知发育。
纳入了 42 项随机对照试验，共纳入了 15557 名婴儿。其中 27 项试验被纳入荟萃分析。来自 13 项试验的汇总数据表明，HCP-ECD 干预措施可能改善 0-36 个月儿童的认知结局（贝利婴幼儿发育量表第三版（BSID-III）平均差值（MD）为 2.65；95%置信区间为 0.61 至 4.70；2482 名参与者；证据确定性低）。来自 9 项试验的汇总数据表明，运动发育有所改善（BSID-III MD 为 4.01；95%置信区间为 1.54 至 6.48；1437 名参与者；证据确定性低）。产妇心理健康没有改善的证据（标准化 MD-0.13；95%置信区间-0.28 至 0.03；2806 名参与者；11 项试验；证据确定性低）。
我们报告了有希望的证据，特别是关于 HCP-ECD 干预措施对认知和运动结局的影响，但其效应大小较小，证据确定性从极低到中等不等。需要开展更多高质量的研究。
PROSPERO 注册号：CRD42019122021。
