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Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis

BACKGROUND: The Millennium Developmental Goals ensured a significant reduction in childhood mortality. However, this reduction simultaneously raised concerns about the long-term outcomes of survivors of early childhood insults. This systematic review focuses on the long-term neurocognitive and menta...

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Autores principales: Magai, Dorcas N., Karyotaki, Eirini, Mutua, Agnes M., Chongwo, Esther, Nasambu, Carophine, Ssewanyana, Derrick, Newton, Charles R., Koot, Hans M., Abubakar, Amina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182387/
https://www.ncbi.nlm.nih.gov/pubmed/32330163
http://dx.doi.org/10.1371/journal.pone.0231947
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author Magai, Dorcas N.
Karyotaki, Eirini
Mutua, Agnes M.
Chongwo, Esther
Nasambu, Carophine
Ssewanyana, Derrick
Newton, Charles R.
Koot, Hans M.
Abubakar, Amina
author_facet Magai, Dorcas N.
Karyotaki, Eirini
Mutua, Agnes M.
Chongwo, Esther
Nasambu, Carophine
Ssewanyana, Derrick
Newton, Charles R.
Koot, Hans M.
Abubakar, Amina
author_sort Magai, Dorcas N.
collection PubMed
description BACKGROUND: The Millennium Developmental Goals ensured a significant reduction in childhood mortality. However, this reduction simultaneously raised concerns about the long-term outcomes of survivors of early childhood insults. This systematic review focuses on the long-term neurocognitive and mental health outcomes of neonatal insults (NNI) survivors who are six years or older. METHODS: Two independent reviewers conducted a comprehensive search for empirical literature by combining index and free terms from the inception of the databases until 10(th) October 2019. We also searched for additional relevant literature from grey literature and using reference tracking. Studies were included if they: were empirical studies conducted in humans; the study participants were followed at six years of age or longer; have an explicit diagnosis of NNI, and explicitly define the outcome and impairment. Medians and interquartile range (IQR) of the proportions of survivors of the different NNI with any impairment were calculated. A random-effect model was used to explore the estimates accounted for by each impairment domain. RESULTS: Fifty-two studies with 94,978 participants who survived NNI were included in this systematic review. The overall prevalence of impairment in the survivors of NNI was 10.0% (95% CI 9.8–10.2). The highest prevalence of impairment was accounted for by congenital rubella (38.8%: 95% CI 18.8–60.9), congenital cytomegalovirus (23.6%: 95% CI 9.5–41.5), and hypoxic-ischemic encephalopathy (23.3%: 95% CI 14.7–33.1) while neonatal jaundice has the lowest proportion (8.6%: 95% CI 2.7–17.3). The most affected domain was the neurodevelopmental domain (16.6%: 95% CI 13.6–19.8). The frequency of impairment was highest for neurodevelopmental impairment [22.0% (IQR = 9.2–24.8)] and least for school problems [0.0% (IQR = 0.0–0.00)] in any of the conditions. CONCLUSION: The long-term impact of NNI is also experienced in survivors of NNI who are 6 years or older, with impairments mostly experienced in the neurodevelopmental domain. However, there are limited studies on long-term outcomes of NNI in sub-Saharan Africa despite the high burden of NNI in the region. TRIAL REGISTRATION: Registration number: CRD42018082119.
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spelling pubmed-71823872020-05-05 Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis Magai, Dorcas N. Karyotaki, Eirini Mutua, Agnes M. Chongwo, Esther Nasambu, Carophine Ssewanyana, Derrick Newton, Charles R. Koot, Hans M. Abubakar, Amina PLoS One Research Article BACKGROUND: The Millennium Developmental Goals ensured a significant reduction in childhood mortality. However, this reduction simultaneously raised concerns about the long-term outcomes of survivors of early childhood insults. This systematic review focuses on the long-term neurocognitive and mental health outcomes of neonatal insults (NNI) survivors who are six years or older. METHODS: Two independent reviewers conducted a comprehensive search for empirical literature by combining index and free terms from the inception of the databases until 10(th) October 2019. We also searched for additional relevant literature from grey literature and using reference tracking. Studies were included if they: were empirical studies conducted in humans; the study participants were followed at six years of age or longer; have an explicit diagnosis of NNI, and explicitly define the outcome and impairment. Medians and interquartile range (IQR) of the proportions of survivors of the different NNI with any impairment were calculated. A random-effect model was used to explore the estimates accounted for by each impairment domain. RESULTS: Fifty-two studies with 94,978 participants who survived NNI were included in this systematic review. The overall prevalence of impairment in the survivors of NNI was 10.0% (95% CI 9.8–10.2). The highest prevalence of impairment was accounted for by congenital rubella (38.8%: 95% CI 18.8–60.9), congenital cytomegalovirus (23.6%: 95% CI 9.5–41.5), and hypoxic-ischemic encephalopathy (23.3%: 95% CI 14.7–33.1) while neonatal jaundice has the lowest proportion (8.6%: 95% CI 2.7–17.3). The most affected domain was the neurodevelopmental domain (16.6%: 95% CI 13.6–19.8). The frequency of impairment was highest for neurodevelopmental impairment [22.0% (IQR = 9.2–24.8)] and least for school problems [0.0% (IQR = 0.0–0.00)] in any of the conditions. CONCLUSION: The long-term impact of NNI is also experienced in survivors of NNI who are 6 years or older, with impairments mostly experienced in the neurodevelopmental domain. However, there are limited studies on long-term outcomes of NNI in sub-Saharan Africa despite the high burden of NNI in the region. TRIAL REGISTRATION: Registration number: CRD42018082119. Public Library of Science 2020-04-24 /pmc/articles/PMC7182387/ /pubmed/32330163 http://dx.doi.org/10.1371/journal.pone.0231947 Text en © 2020 Magai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Magai, Dorcas N.
Karyotaki, Eirini
Mutua, Agnes M.
Chongwo, Esther
Nasambu, Carophine
Ssewanyana, Derrick
Newton, Charles R.
Koot, Hans M.
Abubakar, Amina
Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis
title Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis
title_full Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis
title_fullStr Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis
title_full_unstemmed Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis
title_short Long-term outcomes of survivors of neonatal insults: A systematic review and meta-analysis
title_sort long-term outcomes of survivors of neonatal insults: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182387/
https://www.ncbi.nlm.nih.gov/pubmed/32330163
http://dx.doi.org/10.1371/journal.pone.0231947
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