title: Early sucking and swallowing problems as predictors of neurodevelopmental outcome in children with neonatal brain injury: a systematic review.
abstract: OBJECTIVE
  Early sucking and swallowing problems may be potential markers of neonatal brain injury and assist in identifying those infants at increased risk of adverse outcomes, but the relation between early sucking and swallowing problems and neonatal brain injury has not been established. The aim of the review was, therefore, to investigate the relation between early measures of sucking and swallowing and neurodevelopmental outcomes in infants diagnosed with neonatal brain injury and in infants born very preterm (<32wks) with very low birthweight (<1500g), at risk of neonatal brain injury.
  
  
  METHODS
  We conducted a systematic review of English-language articles using CINAHL, EMBASE, and MEDLINE OVID (from 1980 to May 2011). Additional studies were identified through manual searches of key journals and the works of expert authors. Extraction of data informed an assessment of the level of evidence and risk of bias for each study using a predefined set of quality indicators.
  
  
  RESULTS
  A total of 394 abstracts were generated by the search but only nine studies met the inclusion criterion. Early sucking and swallowing problems were present in a consistent proportion of infants and were predictive of neurodevelopmental outcome in infancy in five of the six studies reviewed.
  
  
  CONCLUSIONS
  The methodological quality of studies was variable in terms of research design, level of evidence (National Health and Medical Research Council levels II, III, and IV), populations studied, assessments used and the nature and timing of neurodevelopmental follow-up.
  
  
  CONCLUSIONS
  Based upon the results of this review, there is currently insufficient evidence to clearly determine the relation between early sucking and swallowing problems and neonatal brain injury. Although early sucking and swallowing problems may be related to later neurodevelopmental outcomes, further research is required to delineate their value in predicting later motor outcomes and to establish reliable measures of early sucking and swallowing function.
authors.affiliation: School of Human Communication Sciences, La Trobe University, Melbourne, Victoria, Australia. j.slattery@latrobe.edu.au
authors.forename: Justine
authors.initials: J
authors.lastname: Slattery
authors.forename: Angela
authors.initials: A
authors.lastname: Morgan
authors.forename: Jacinta
authors.initials: J
authors.lastname: Douglas
mesh_terms: D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000503:physiopathology*; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000503:physiopathology*; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D009460:Neurologic Examination; D011379:Prognosis; D012307:Risk Factors; D013223:Statistics as Topic; D013391:Sucking Behavior / Q000502:physiology*