Link: http://www.ncbi.nlm.nih.gov/pubmed/26831532

J Pediatr Surg. 2016 Jan 5. pii: S0022-3468(15)00835-0. doi: 10.1016/j.jpedsurg.2015.12.010. [Epub ahead of print]
Younger gestational age is associated with increased risk of adverse neurodevelopmental outcome during infancy in congenital diaphragmatic hernia.
Danzer E1, Gerdes M2, D'Agostino JA2, Bernbaum J2, Hoffman C2, Herkert LM2, Rintoul NE2, Peranteau WH2, Flake AW2, Adzick NS2, Hedrick HL2.
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Abstract
BACKGROUND:
The purpose of the study was to investigate the impact of gestational age (GA) on short-term neurodevelopmental (ND) outcomes in congenital diaphragmatic hernia survivors.
MATERIALS:
Between 6/2004 and 2/2013, 135 consecutive CDH patients underwent ND assessment using the Bayley Scales of Infant Development-III at a median follow-up age of 13months (range, 5-36). ND delay was defined by a score of ≤85 in any of the composite scales. Severe impairment was defined as a score of ≤69 in at least one domain. The effect of GA was evaluated as continuous and categorical variables. GA at delivery was grouped into full term (39-41weeks), near term (37-3, late preterm (34-36), and preterm (24-33).
RESULTS:
Median GA at delivery was 38weeks (range, 24-41). Fifty (37%) patients were delivered full term, 59 (44%) near term, 16 (12%) late preterm, and 10 (7%) preterm. CDH children born before 39weeks' gestation were more likely to score below average (P=0.005) with corrected age for at least one composite score compared to full term peers. Cognitive (P=0.06) and language (P=0.0 scores tended to be lower in the near-term and late-preterm group compared to full-term CDH infants. Patients born near term and late preterm had significantly lower motor composite and fine motor scores compared to full-term children (P=0.009 and P<0.01, respectively). Preterm children scored the lowest in all composite scales (P<0.05).
CONCLUSIONS:
Compared to term infants, not only preterm but also late preterm and near-term CDH children carry an increased risk of ND delays. Motor performance appears most susceptible to earlier delivery.
Copyright © 2016 Elsevier Inc. All rights reserved.
KEYWORDS:
Bayley scales of infant development; Congenital diaphragmatic hernia; Neurodevelopmental outcome; Preterm; Pulmonary hypoplasia
PMID: 26831532 [PubMed - as supplied by publisher]