The Influence of preterm birth beyond infancy: Umbrella review of outcomes of adolescents and adults born preterm.

Abstract

In recent decades, increased neonatal survival has enabled research of long-term outcomes of those born preterm. The purpose of this article is to present the findings of an umbrella review, an examination of published systematic reviews and meta-analyses, to examine the outcomes of adolescents and adults born preterm. The research was guided by the Joanna Briggs Institute methodology for umbrella reviews. A systematic search of PubMed, CINAHL, and PsycINFO databases with the search years 2010 through September 2018 yielded 16 reviews for inclusion. The 16 reviews included in this umbrella review represent five clinical outcomes: neurodevelopmental (3 reviews), mental/behavioral health (5 reviews), cardiovascular (4 reviews), pulmonary (3 reviews), and life experience outcomes (4 reviews). One review included data for multiple clinical outcomes. This umbrella review highlights the adolescent and adult risks related to cognitive scores, executive function, anxiety, depression, attention-deficit hyperactivity disorder, long-term effects on systolic blood pressure, low-density lipoproteins and cholesterol levels, pulmonary symptoms, including asthma, pulmonary function, radiographic changes in the lungs, sports and leisure participation, and educational attainment and employment. There is a preponderance of evidence that supports targeted screening for a history of preterm birth by all health care providers. This screening should facilitate the promotion of healthy lifestyles and improving psychosocial and neurodevelopmental difficulties through early and continued support services. Curricular and practice standards are advocated to support this change.