The risk of early neurodevelopmental delay is increasingly recognized in children born moderate-to-late preterm (MLP; 32-36 weeks' gestation), but school-aged cognitive outcomes are unclear, particularly for domains such as executive function (EF). To evaluate EF outcomes (attentional control, cognitive flexibility, and goal setting) in school-aged children born MLP compared with children born at term. Medline, Embase, PsycInfo, and Scopus. Studies assessing EF outcomes (overall EF, attentional control, cognitive flexibility, and goal setting) in children born MLP aged between 6 and 17 years, which included a term-born control group. Two reviewers screened for eligibility and completed the risk of bias assessment using the Newcastle-Ottawa Scale, and 1 reviewer extracted data. Random effects meta-analyses were performed. Twelve studies were eligible for inclusion in the meta-analyses (2348 MLP children and 20 322 controls). Children born MLP had poorer overall EF compared with children born at term (standardized mean difference, -0.15, 95% confidence interval, -0.21 to -0.09; P < .0001; I2 = 47.59%). Similar conclusions were noted across the subdomains of attentional control, cognitive flexibility, and goal setting. Study methodologies and EF measures varied. Only a small number of studies met eligibility criteria and were from developed countries. School-aged children born MLP may experience greater challenges in EF compared with term-born children. Further research is needed to investigate the potential impact these challenges have on functional outcomes such as academic achievement and social-emotional functioning.
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