Long-term child follow-up after randomized controlled trials evaluating prevention of preterm birth interventions: a systematic review
Presented by Larissa van der Windt
Although obstetric interventions can have unexpected long-term effects, evaluation of long-term child outcomes is not standardized. The aim of this study is to give an overview of long-term follow-up studies after randomized controlled trials (RCTs) evaluating interventions to prevent preterm birth in asymptomatic pregnant women.
A search was performed in MEDLINE, Embase and Cochrane Central Library. Titles and abstracts were screened in duplicate. Secondly, eligible RCT’s were crosschecked using WebofScience to find any publication on long term child outcomes of these RCTs (defined as after discharge from hospital). Proportion of RCTs reporting long-term child outcomes was calculated. Also, data on age at follow-up, domains studied, and measurement instrument used were extracted.
181 RCTs were identified evaluating interventions to prevent preterm birth of which 14 assessed long-term child outcomes (8%). Two RCTs performed two follow-up studies, leading to a total of 16 publications. Most follow-up was performed below age of 5 years, but ranged between 6 months and 16 years of age. In 13/16 (81%) of the follow-up publications, neurodevelopment was the primary domain studied. In total, 14 different standardized measurement instruments were used to report on long-term child outcomes. The Ages and Stages Questionnaire (ASQ) was most frequently used in 7/16 (44%) publications.
Only a minority of RCTs evaluating prevention of preterm birth interventions evaluate long-term child outcomes. These outcomes are however crucial for counseling on these interventions. Consensus on a core set of measurement instrument will help to compare and aggregate findings of follow-up studies.
Larissa van der Windt