The impact of premature birth and low birth weight on motor, visual, and cognitive skills and mental health in adolescence: a systematic review and meta-analysis

Mental disorders represent a significant challenge for individuals and society. Many of them have a detectable onset during adolescence. Being born preterm or with low birth weight (PTB) has been emerging as a potential risk factor for developing mental health disorders in adolescence. Since PTB infants are considered to be at an increased risk of cognitive and sensory difficulties and are at risk for visual impairments, this systematic review aims to explore (1) whether evidence for a possible interplay between PTB, cognitive, visual, and motor abilities exists in the literature, and (2) whether and how these factors may relate to mental health outcomes of PTB individuals in adolescence. We conducted a registered systematic review following the PRISMA guidelines (PROSPERO #42024513150). The search strategy focused on the databases PubMed, Scopus, PsycINFO and the Cochrane Library and included publications sampling participants born in 1980 or later. Upon screening 499 studies, we analysed 17 studies including a total of 10,842 adolescents aged 11-20 (PTB = 8,813, control = 4,029) published between 2005 and 2022. PTB adolescents exhibited deficits in cognitive and motor domains compared to their full-term peers (≥ 37 gestational weeks; FT), including lower intelligence quotient (IQ), attention and executive function, and motor control. These effects can persist into adolescence and even adulthood. Importantly, several studies demonstrated that PTB adolescents receive diagnoses of psychiatric disorders more often and get diagnosed with more complex psychiatric disorders. Contrarily, evidence for subtle visual alterations and direct links between PTB, the reviewed domains and mental health outcomes remains scarce. These findings highlight that PTB adolescents can face challenges across multiple separate domains, including an elevated prevalence of psychiatric diagnoses. Clarifying the nature of these observational relationships shall provide insights that could improve early detection approaches and targeted intervention in the future.