Currently submitted to: JMIR Pediatrics and Parenting
Date Submitted: Apr 16, 2026
Open Peer Review Period: Apr 21, 2026 - Jun 16, 2026
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The impact of post-discharge medical aftercare on developmental outcomes in preterm infants and parent-child interactions: a systematic review
ABSTRACT
Background:
Preterm infants (<37 weeks gestational age) remain at increased risk of developmental challenges, potentially influenced by parent-child interactions and parental competencies.
Objective:
To systematically evaluate the evidence on post-discharge nursing or midwifery care or sociomedical aftercare and their effects on developmental outcomes in preterm infants and parent-child interactions compared with preterm infants receiving standard of care.
Methods:
Five databases were searched for randomised controlled trials (RCTs) and non-randomised studies of intervention (NRSIs) from inception until December 11, 2024. Studies including preterm infants (<37 weeks gestational age) receiving post-discharge medical aftercare were eligible. Children born full-term (≥37 weeks gestational age) and early intervention programmes with a therapeutic approach were excluded. Two reviewers independently screened records and extracted data from studies that examined following predefined outcomes: participation, quality of life, rehospitalisation, behaviour, and parent-child interaction. Risk of bias was assessed using Cochrane RoB2 for RCTs and ROBINS-I for NRSIs. Clinically and methodologically comparable studies were combined in random-effects meta-analyses. Certainty of evidence was evaluated using the Grading of Recommendations, Assessments, Development and Evaluation (GRADE) approach.
Results:
Sixteen studies investigating 3,047 preterm children (gestational age 24-37 weeks) aged three months to five years were included. Data on rehospitalisation, regulatory disorders, risk of maltreatment, parent-child enrichment and attachment were reported with very low to low certainty evidence. Medical aftercare may slightly improve the parent-child enrichment, while effects on other outcomes remain uncertain. No studies reported data on participation, quality of life nor emotional or conduct problems.
Conclusions:
Findings reveal a substantial evidence gap and underline the need for further research, particularly focusing on midwifery care and sociomedical aftercare. (Funding: DLR No. MEDLL1_2022-025.) Clinical Trial: PROSPERO: CRD420251023174
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