Original Article
Language Abilities in Children Who Were Very Preterm and/or Very Low Birth Weight: A Meta-Analysis

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Objective

To conduct a meta-analysis to characterize differences in language ability between children born very preterm (VPT, <32 weeks’ gestational age), with a very low birth weight (VLBW, <1500 g), or both and in term-born control children.

Study design

Electronic databases were systematically searched, and 12 studies met the inclusion criteria. Effect sizes were calculated to compare VPT/VLBW children and control children.

Results

VPT/VLBW children performed between 0.38 and 0.77 SD below control subjects in the areas of expressive and receptive language overall and expressive and receptive semantics. Results for expressive and receptive grammar were equivocal. Subgroup analysis of school-aged children revealed similar results. No studies assessing phonological awareness, discourse, or pragmatics were identified.

Conclusions

Language ability is reduced in VPT/VLBW children. When considering only school-aged children, this reduction is still present, suggesting that their difficulty appears to be ongoing. Rigorous studies examining a range of language subdomains are needed to fully understand the specific nature of language difficulties in this population.

Section snippets

Methods

The literature was searched systematically with the electronic databases MEDLINE, PsycINFO, CINAHL, and ERIC, for articles published between 1990 and November 2009 inclusive. Search terms are listed in Table I (available at www.jpeds.com). The searches were restricted to English-language publications in peer-reviewed journals. The broad keyword search had high sensitivity and yielded a total of 3386 items.

Studies were examined to determine whether they met these inclusion criteria: (1) examined

Results

Table III depicts the number of studies, total sample sizes, effect sizes, CIs, I2 statistics, and fail-safe N statistics for each language subdomain, categorized by age at assessment. When the category contained only 1 study, a meta-analysis could not be conducted, and so the statistics pertain only to the individual study identified with the systematic review.

Discussion

We demonstrate that VPT/VLBW children perform less well than control children on overall expressive and receptive language measures and in the more specific subdomains of expressive and receptive semantics. The results for expressive and receptive grammar were equivocal, with only one study in each subdomain and a low fail safe N statistic for the single significant effect size. No studies in the subdomains of phonological awareness, discourse, or pragmatics were identified.

The effect sizes

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    Supported by Australia’s National Health & Medical Research Council (Career Development Award for A.M. [ID–607315] and Senior Research Fellowship for P.A. [ID – 628371]). The authors declare no conflicts of interest.

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