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Aim: The associations between the aetiology of preterm birth and later neurodevelopmental outcomes are unclear. A systematic review and meta‐analysis examined the existing evidence. Methods: The PubMed and Embase databases were searched for papers published in English from inception to 16 December 2020. We included original papers on the causes of preterm birth and the risks of cerebral palsy (CP) and suboptimal cognitive development. Two reviewers independently evaluated the studies and extracted the data. Results: The literature search yielded 5472 papers and 13 were selected. The aetiology of preterm birth was classified under spontaneous or medically indicated delivery. A meta‐analysis was performed, comprising 104 902 preterm infants from 11 papers on CP. Preterm infants born after a medically indicated delivery had a lower CP risk than infants born after spontaneous delivery, with a pooled odds ratio of 0.59 (95% confidence interval 0.40–0.86). This result was robust in the subgroup and sensitivity analyses. Cognitive development was reported in three papers, which suggested that worse outcomes were associated with medically indicated deliveries. Conclusion: The aetiology of preterm delivery may contribute to the risk of CP and cognitive delay. Further research is needed, using individual‐level meta‐analyses to adjust for possible confounders, notably gestational age. [ABSTRACT FROM AUTHOR]

Background: Preterm infants have a risk of health and developmental problems emerging after discharge. This indicates the need for a comprehensive follow-up to enable early identification of these problems. In this paper, we introduce a follow-up tool "ePIPARI – web-based follow-up for preterm infants". Our future aim is to investigate whether ePIPARI is a feasible tool in the follow-up of preterm infants and whether it can identify children and parents in need of clinical interventions. Methods: ePIPARI includes eight assessment points (at term age and at 1, 2, 4, 8, 12, 18, and 24 months of corrected age) when the child´s health and growth, eating and feeding, neurodevelopment, and parental well-being are evaluated. ePIPARI consists of several widely used, standardized questionnaires, in addition to questions typically presented to parents in clinical follow-up visits. It also provides video guidance and written information about age-appropriate neurodevelopment for the parents. Parents of children born before 34 weeks of gestation during years 2019–2022 are being invited to participate in the ePIPARI study, in which web-based follow-up with ePIPARI is compared to clinical follow-up. In addition, the parents of children born before 32 weeks of gestation, who reached the corrected age of two years during 2019–2021 were invited to participate for the assessment point of 24 months of ePIPARI. The parents are asked to fill in the online questionnaires two weeks prior to each clinical follow-up visit. Discussion: The web-based tool, ePIPARI, was developed to acquire a sensitive and specific tool to detect infants and parents in need of further support and clinical interventions. This tool could allow individualized adjustments of the frequency and content of the clinical visits. Trial registration: ClinicalTrials.cov, NCT05238168. Registered 11 April 2022 – Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Chorioamnionitis, a risk factor for preterm delivery, has been suggested to be associated with suboptimal neurological development in premature infants. Objective: To evaluate the association between chorioamnionitis and neurodevelopment in preterm infants at 5 years of age. Methods Very low birth weight and very low gestational age infants (n = 197) were recruited. Placental samples (n = 117) were evaluated for histological chorioamnionitis. Fetal histological chorioamnionitis was analyzed as a subgroup. The diagnosis of clinical chorioamnionitis was derived from medical records. Neurodevelopmental impairments were evaluated at 2 years of age, and cognitive development (n = 188) and neuropsychological performance (n = 193) were evaluated at 5 years of age. Results: There were no associations between histological or clinical chorioamnionitis and neurodevelopmental impairments at 2 years of age. Clinical chorioamnionitis and fetal histological chorioamnionitis were not associated with cognitive development or neuropsychological performance, but histological chorioamnionitis was associated with poorer cognitive outcome (regression coefficient = -7.22, 95% CI: -14.31 to -0.13) and weaker memory and learning functions (regression coefficient = -1.29, 95% CI: -2.40 to -0.18) at 5 years of age. Conclusion: Our study findings do not support clinical chorioamnionitis having a major independent role in the pathogenesis of neurodevelopmental problems in very preterm infants. Histological chorioamnionitis was associated with slightly less optimal performance at 5 years of age, but further studies are needed to verify the clinical significance of these findings. [ABSTRACT FROM AUTHOR]

Background. Chorioamnionitis is an important risk factor underlying preterm delivery, and it has also been suggested that it is associated with brain lesions and deviant neurological development in prematurely born infants. Objective. To evaluate the possible effects of chorioamnionitis on the brain of preterm infants. Design. A systematic review. Methods. A systematic database search was performed to identify all original articles published until 5 October 2011 evaluating the association between histological and/or clinical chorioamnionitis and brain lesions and/or neurological development in preterm infants. Altogether, 609 potentially relevant articles were identified, of which 84 original articles were included. Results. The majority of the articles do not support the hypothesis that chorioamnionitis poses a direct risk on the central nervous system of preterm infants. The full course of antenatal steroids seems to further reduce the adverse effects of inflammation on the developing nervous system. Conclusions. It seems that there are both benefits and risks with regard to the effects of chorioamnionitis on the brain development of preterm infants. It is plausible that inflammation enhances maturation of the preterm infant and therefore has protective effects balancing its potential harmful effects. We conclude that chorioamnionitis does not carry higher risks for the brain of preterm infants than other underlying pathologies behind preterm delivery. [ABSTRACT FROM AUTHOR]