Early Developmental Outcomes following Major Noncardiac and Cardiac Surgery in Term Infants: A Population-Based Study

Walker, Karen; Badawi, Nadia; Halliday, Robert; Stewart, Jan; Sholler, Gary F.; Winlaw, David S.; Sherwood, Megan C.; Holland, A.J.A.

doi:10.1016/j.jpeds.2012.03.044

Cited by 81 publications

(88 citation statements)

References 33 publications

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“…Therefore, these complications must suggest to clinicians that a patient's severity of illness puts that patient at extremely high risk for impaired neurological function. Of note, non-ECMO treated CDH survivors appear to be at similar risk as children that underwent surgical intervention for other congenital malformations during the neonatal period and also require prolonged hospitalization during the first year of life [19]. Thus, further research is needed to fully delineate whether the underlying malformation, its treatment, or both impact on short-term neurological outcome.…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation

Danzer

Gerdes

D’Agostino

et al. 2015

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation

Danzer

Gerdes

D’Agostino

et al. 2015

Journal of Pediatric Surgery

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“…35–46 The observed outcome measures ranged from individual neurodevelopmental testing at 18–22 months to learning disabilities identified during childhood and school achievement assessed by group testing at 19 years. Most, 35–43 but not all, 44–46 studies reported worse neurodevelopmental or achievement outcomes for patients who had surgery than for others, and some reported increasing risk with multiple surgical exposures. 35, 38, 40 …”

Section: Discussionmentioning

confidence: 99%

Surgery and Neurodevelopmental Outcome of Very Low-Birth-Weight Infants

et al. 2014

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IMPORTANCE Reduced death and neurodevelopmental impairment among infants is a goal of perinatal medicine. OBJECTIVE To assess the association between surgery during the initial hospitalization and death or neurodevelopmental impairment of very low birth weight infants. DESIGN Retrospective cohort analysis of patients enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998–2009 and evaluated at 18–22 months’ corrected age. SETTING 22 academic neonatal intensive care units. PARTICIPANTS Inclusion criteria were: birth weight 401–1500 g; survival to 12 hours; available for follow-up. Some conditions were excluded. 12 111 infants were included in analyses, 87% of those eligible. EXPOSURES Surgical procedures; surgery also classified by expected anesthesia type as major (general anesthesia) or minor surgery (non-general anesthesia). MAIN OUTCOME MEASURES Multivariable logistic regression analyses planned a priori were performed for the primary outcome of death or neurodevelopmental impairment and for the secondary outcome of neurodevelopmental impairment among survivors. Multivariable linear regression analyses were performed as planned for the adjusted means of Bayley Scales of Infant Development, Second Edition, Mental Developmental Index and Psychomotor Developmental Index for patients born before 2006. RESULTS There were 2186 major, 784 minor and 9141 no surgery patients. The risk-adjusted odds ratio of death or neurodevelopmental impairment for all surgery patients compared with those who had no surgery was 1.29 (95% confidence interval 1.08–1.55). For patients who had major surgery compared with those who had no surgery the risk-adjusted odds ratio of death or neurodevelopmental impairment was 1.52 (95% confidence interval 1.24–1.87). Patients classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who had no surgery the adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26–1.93) and the adjusted mean Mental Developmental Index and mean Psychomotor Developmental Index values were lower. CONCLUSIONS AND RELEVANCE Major surgery in very low birth weight infants is independently associated with a greater than 50% increased risk of death or neurodevelopmental impairment and of neurodevelopmental impairment at 18–22 months’ corrected age. The role of general anesthesia is implicated but remains unproven.

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“…Healthy newborn infants were enrolled as controls from 1 August 2006, to 31 July 2008, as the control group in a prospective population-based cohort study comparing the neurodevelopmental outcome of infants in New South Wales (NSW) who had undergone early major surgery with control infants 22. Infants with a known chromosomal anomaly were excluded from the control group.…”

Section: Methodsmentioning

confidence: 99%

A comparison of the performance of healthy Australian 3-year-olds with the standardised norms of the Bayley Scales of Infant and Toddler Development (version-III)

Chinta

Walker

Halliday

et al. 2014

Archives of Disease in Childhood

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Healthy term Australian children have a statistically significantly higher mean score on the Bayley Scales of Infant and Toddler Development (version-III) compared with the standardised means in four of the subtests, with the greatest difference in receptive language. This has implications for the assessment of children as the test may miss those with a minor delay and not reflect the severity of delay of infants that it does identify. We recommend that consideration ought to be given to re-standardising this assessment on Australian children.

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Early Developmental Outcomes following Major Noncardiac and Cardiac Surgery in Term Infants: A Population-Based Study

Cited by 81 publications

References 33 publications

Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation

Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation

Surgery and Neurodevelopmental Outcome of Very Low-Birth-Weight Infants

A comparison of the performance of healthy Australian 3-year-olds with the standardised norms of the Bayley Scales of Infant and Toddler Development (version-III)

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