Stolwijk LJ, Lemmers PM, Harmsen M, Groenendaal F, de Vries LS, van der Zee DC, Benders MJN, van Herwaarden-Lindeboom MYA. Neurodevelopmental Outcomes After Neonatal Surgery for Major Noncardiac Anomalies.
Pediatrics 2016;
137:e20151728. [PMID:
26759411 DOI:
10.1542/peds.2015-1728]
[Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/24/2022] Open
Abstract
CONTEXT
Increasing concerns have been raised about the incidence of neurodevelopmental delay in children with noncardiac congenital anomalies (NCCA) requiring neonatal surgery.
OBJECTIVE
This study aimed to determine the incidence and potential risk factors for developmental delay after neonatal surgery for major NCCA.
DATA SOURCES
A systematic search in PubMed, Embase and the Cochrane Library was performed through March 2015.
STUDY SELECTION
Original research articles on standardized cognitive or motor skills tests.
DATA EXTRACTION
Data on neurodevelopmental outcome, the Bayley Scales of Infant Development, and risk factors for delay were extracted.
RESULTS
In total, 23 eligible studies were included, reporting on 895 children. Meta-analysis was performed with data of 511 children, assessed by the Bayley Scales of Infant Development at 12 and 24 months of age. Delay in cognitive development was reported in a median of 23% (3%-56%). Meta-analysis showed a cognitive score of 0.5 SD below the population average (Mental Development Index 92 ± 13, mean ± SD; P < .001). Motor development was delayed in 25% (0%-77%). Meta-analysis showed a motor score of 0.6 SD below average (Psychomotor Development Index 91 ± 14; P < .001). Several of these studies report risk factors for psychomotor delay, including low birth weight, a higher number of congenital anomalies, duration of hospital admission, and repeated surgery.
LIMITATIONS
All data were retrieved from studies with small sample sizes and various congenital anomalies using different neurodevelopmental assessment tools.
CONCLUSIONS
Cognitive and motor developmental delay was found in 23% of patients with NCCA. Meta-analysis showed that the mean neurodevelopmental outcome scores were 0.5 SD below the normative score of the healthy population.
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