Ha-Vinh Leuchter Russia, Siffredi Vanessa
Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Department of Radiology, Lausanne University Hospital and University of Lausanne, Switzerland.
J Dev Behav Pediatr. 2024;45(6):e585-e595. doi: 10.1097/DBP.0000000000001316. Epub 2024 Oct 4.
To systematically review nonpharmaceutical interventions aiming to enhance neurodevelopment in preterm children and adolescents (aged 4-18 years).
A systematic review of the literature was conducted for all studies published up to May 1, 2022, across Medline, Web of Science, and PsycINFO databases. Studies were evaluated for inclusion by 2 independent reviewers using predetermined inclusion criteria. The Risk of Bias In Non-randomized Studies of Interventions and the Cochrane risk-of-bias tool for randomized trials (RoB 2) tools were used to assess bias in the selected studies.
Of the 1778 articles identified, 23 were included. Quality assessment revealed moderate bias in 52.2%, low bias in 21.7%, and serious bias in 26.1%. The selected studies comprised 60.9% randomized controlled trials and 21.7% pre- versus postdesigns. Interventions included Cogmed Working Memory Training® (43.5%), BrainGame Brian (13%), physiotherapy (13%), and others (30.4%). Qualitative analysis showed the limited impact of interventions on neurodevelopmental outcomes in preterm children aged 4-18 years.
Despite recent efforts to use more rigorous methodologies, current research on school-age interventions for preterm neurodevelopment exhibits methodological limitations. There is a pressing need for well-designed, large-scale clinical trials to evaluate the efficacy of nonpharmaceutical interventions in this vulnerable population.
系统评价旨在促进早产儿童和青少年（4至18岁）神经发育的非药物干预措施。
对截至2022年5月1日在Medline、科学网和PsycINFO数据库中发表的所有研究进行文献系统评价。由2名独立评审员根据预先确定的纳入标准对研究进行纳入评估。采用干预非随机研究中的偏倚风险工具和随机试验的Cochrane偏倚风险工具（RoB 2）来评估所选研究中的偏倚。
在识别出的1778篇文章中，纳入了23篇。质量评估显示，52.2%存在中度偏倚，21.7%存在低度偏倚，26.1%存在严重偏倚。所选研究包括60.9%的随机对照试验和21.7%的前后设计。干预措施包括Cogmed工作记忆训练®（43.5%）、BrainGame Brian（13%）、物理治疗（13%）和其他（30.4%）。定性分析表明，干预措施对4至18岁早产儿童神经发育结局的影响有限。
尽管最近努力采用更严格的方法，但目前关于早产神经发育的学龄期干预研究存在方法学局限性。迫切需要设计良好的大规模临床试验来评估非药物干预措施对这一弱势群体的疗效。
