title: Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review.
abstract: OBJECTIVE
  The aim of this study was to review the effects of early developmental intervention after discharge from hospital on motor and cognitive development in preterm infants.
  
  
  METHODS
  Randomized controlled trials (RCTs) or quasi-RCTs of early developmental intervention programmes for preterm infants in which motor or cognitive outcomes were reported and in which the intervention commenced before or after discharge were included. A systematic review and meta-analysis of studies grouped by intervention, age of outcome, and study quality was undertaken. Databases searched (up to January 2009) included the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, PsycINFO, and Embase.
  
  
  RESULTS
  Eighteen studies met the inclusion criteria (2686 patients randomized), but only 11 studies had data suitable for meta-analysis. Early developmental intervention improved cognitive outcomes at infant age (developmental quotient: standardized mean difference [SMD] 0.42, 95% confidence interval [CI] 0.33-0.52; p<0.001), and at preschool age (IQ: SMD 0.46, 95% CI 0.33-0.59; p<0.001). However, the benefit was not sustained at school age (IQ: SMD 0.02, 95% CI -0.10 to 0.14; p=0.71). Early intervention had little effect on motor outcome at infant or school age, and there was no study reporting motor outcome at preschool age.
  
  
  CONCLUSIONS
  Current evidence suggests that the benefits of developmental intervention postdischarge are restricted to short-term gains in cognitive outcome.
authors.affiliation: The Royal Women's Hospital, Melbourne, Australia. jane.orton@thewomens.org.au
authors.forename: Jane
authors.initials: J
authors.lastname: Orton
authors.forename: Alicia
authors.initials: A
authors.lastname: Spittle
authors.forename: Lex
authors.initials: L
authors.lastname: Doyle
authors.forename: Peter
authors.initials: P
authors.lastname: Anderson
authors.forename: Roslyn
authors.initials: R
authors.lastname: Boyd
mesh_terms: D000293:Adolescent; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D018479:Early Intervention, Educational; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D007360:Intelligence; D009048:Motor Skills / Q000502:physiology*