Conclusions
On current best evidence and considering all the provisos outlined
above, we conclude that early-term birth for LGA babies, in particular
at 38 weeks, is not likely to reduce cognitive outcome to a clinically
significant degree at the population level. For LGA children in
particular, a large RCT and/or cohort study with long-term follow-up is
urgently needed to confirm whether the slight advantage of being larger
in terms of cognitive development can compensate for the slight
disadvantage of being born two weeks earlier. These studies will
contribute greatly to helping obstetricians and parents weigh the pros
and cons of making the best possible decision about the timing of
labour.
Acknowledgements : The BB2UP grant supports this Online Open
publication through a legacy gift from University of Warwick alumnus
Jack Straw (BSc Mathematics and Economics, 1969-72).
Disclosure of Interests : All authors confirm no conflicts of
interest.
Contribution to Authorship : XZ, SQ and DW were responsible for
the design and conception of the research question. XZ and DW designed
the methodology. XZ and AP undertook literature search, study selection
and checked by DW. XZ and MS conducted the data extraction and risk
assessment. XZ did statistical analysis and designed the tables, figures
and online-only supplements. The initial drafts of the manuscript were
prepared by XZ and DW, with additional input from SQ, MS and AP. All
authors contributed to the final version of the manuscript.
Details of ethics approval : This study did not require ethical
approval as the data used have been published previously.