Department of Obstetrics and Gynaecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
Amsterdam UMC Location University of Amsterdam, Medical Library, Amsterdam, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 2024 Dec;303:35-41. doi: 10.1016/j.ejogrb.2024.10.014. Epub 2024 Oct 10.
Obstetric interventions can have unexpected long-term effects on child development. However, evaluation of these outcomes is not standard in current research.
To give an overview of long-term follow-up studies after randomised controlled trials (RCTs) evaluating interventions to prevent preterm birth in asymptomatic pregnancies.
Databases MEDLINE, Embase and Cochrane Central Library were searched for relevant RCTs. WebofScience was crosschecked for citations of these RCTs for publications on long-term child outcomes.
RCTs evaluating interventions to prevent preterm birth in asymptomatic pregnant women. A long-term follow-up study was defined as such when child outcomes were assessed after discharge from hospital after birth.
Proportion of RCTs with long-term child follow-up was calculated with 95% confidence intervals (CI). Data on child's age at follow-up, outcome domains evaluated and measurement instruments were extracted.
We included 188 RCTs that evaluated interventions to prevent preterm birth. Only 15 of these RCTs assessed long-term child outcomes (8.0%; 95% CI 4.5 to 12.8) with 17 publications (two RCTs performed two follow-up studies). In 13 out of 17 (76.5%) follow-up publications, neurodevelopment was the primary outcome domain studied for which seven different standardized measurement tools were used. In total, 14 different standardized measurement tools were used to assess long-term outcomes. Overall conclusion regarding the effectiveness of the intervention changed in six studies (6/14 studies; 42.9%) based on long-term follow-up findings compared to the original RCT.
Only a minority of the RCTs evaluating prevention of preterm birth interventions performed a long-term follow-up study to assess long-term outcomes on child development. However, the overall conclusions changed in one third of cases. Performance of follow-up studies should be standard in this population in order to counsel parents on potential childhood effects.
Amsterdam Reproduction and Development.
产科干预措施可能对儿童发育产生意想不到的长期影响。然而，目前的研究并没有对这些结果进行评估。
综述随机对照试验（RCT）评估预防无症状妊娠早产干预措施后的长期随访研究。
检索 MEDLINE、Embase 和 Cochrane 中央图书馆数据库，以寻找相关 RCT。交叉核对 WebofScience，以查找这些 RCT 的参考文献中关于长期儿童结局的出版物。
评估预防无症状孕妇早产干预措施的 RCT。长期随访研究定义为在分娩后出院后评估儿童结局的研究。
计算具有长期儿童随访的 RCT 的比例，并计算 95%置信区间（CI）。提取儿童随访时的年龄、评估的结局领域和测量工具的数据。
我们纳入了 188 项评估预防早产干预措施的 RCT。只有 15 项 RCT 评估了长期儿童结局（8.0%；95%CI 4.5 至 12.8），涉及 17 项出版物（两项 RCT 进行了两项随访研究）。在 17 项随访出版物中的 13 项（76.5%）中，神经发育是研究的主要结局领域，使用了七种不同的标准化测量工具。总共使用了 14 种不同的标准化测量工具来评估长期结局。与原始 RCT 相比，根据长期随访结果，有 6 项研究（14 项研究中的 6 项；42.9%）的干预措施有效性的总体结论发生了变化。
评估预防早产干预措施的 RCT 中，只有少数进行了长期随访研究以评估儿童发育的长期结局。然而，在三分之一的情况下，总体结论发生了变化。在这一人群中，应该进行随访研究，以便向父母提供潜在的儿童影响的信息。
阿姆斯特丹生殖与发育。
