loading page

Cognitive and academic outcomes of large-for-gestational-age babies born at early-term: a systematic review and meta-analysis
  • +2
  • Dieter Wolke,
  • Xuan ZHAO,
  • Alice POSKETT,
  • Marie STRACKE,
  • Siobhan Quenby
Dieter Wolke
University of Warwick Department of Psychology

Corresponding Author:d.wolke@warwick.ac.uk

Author Profile
Xuan ZHAO
University of Warwick Department of Psychology
Author Profile
Alice POSKETT
University of Warwick Medical School
Author Profile
Marie STRACKE
University of Warwick Department of Psychology
Author Profile
Siobhan Quenby
University of Warwick Medical School
Author Profile

Abstract

ABSTRACT (250 words) Background: Early induction of labour (38 +0-38 +4 weeks) in large-for-gestational-age (LGA) babies may reduce risks such as shoulder dystocia but may increase another risk of reduced cognitive abilities in offspring. Objectives: To evaluate the cognitive and academic outcomes of LGA children born at early-term (combined exposures or independently) in the light of existing research. Search Strategy: 5 databases were searched from inception to March 2023 without language restrictions. Selection Criteria: Studies reporting on cognitive or academic outcomes either focusing on children born at early-term or LGA. Data Collection and Analysis: Besides narrative synthesis, we conducted meta-analyses where possible. Main Results: Out of 1592 identified articles, no study investigated the effect of early-term delivery in LGA babies on cognitive or academic outcomes. 68 articles investigated the cognitive effects of early-term delivery and LGA independently. Children born at 37 weeks (SMD, -0.13; 95% CI, -0.21 – -0.05) but not at 38 weeks (SMD, -0.04; 95% CI, -0.08 – 0.002) have lower cognitive scores than at 40 weeks. LGA children had slightly higher cognitive scores than AGA children (SMD, 0.06; 95% CI, 0.01 – 0.11). Syntheses results using cognitive impairment or academic performance as outcomes were similar. Conclusions: There is no existing study that investigated early-term delivery in LGA babies and their cognitive scores. Early-term delivery has a small detrimental effect on cognitive scores, whereas LGA may have a small benefit. Evidence from RCTs or observation studies is needed. Fundings: University of Warwick; UKRI (EP/X023206/1) Keywords: cognitive, intelligence, academic performance, early-term delivery, large-for-gestational-age, macrosomia, meta-analysis, systematic review