Neurodevelopmental outcome of infants with gastroschisis at one-year follow-up.

OBJECTIVE: Gastroschisis is a congenital malformation of the abdominal wall and may be associated with significant neonatal mortality and morbidity. The primary objective of this study was to describe the neurodevelopmental outcomes of neonates with this condition. METHODS: Medical records of all neonates admitted with a diagnosis of gastroschisis to a tertiary surgical unit from October 2006 to August 2011 were retrospectively reviewed. Demographic and clinical variables were collated along with developmental assessment results at one-year follow-up. Developmental assessment results were compared with case matched healthy control neonates of similar gestational age and birth weight. RESULTS: Of 20 patients in the study, 16 had simple and four had complex gastroschisis. Mean birth weight was 2.29 kg with a mean gestational age of 35.7 weeks. The majority of neonates underwent primary surgical repair, while 15% had a silo followed by surgical repair. Neonates with gastroschisis did not significantly differ from the control group in neurodevelopmental outcomes. Receptive and expressive language delay was found in gastroschisis is attributable to small for gestational age rather than the malformation per se. CONCLUSIONS: These data suggest that neurodevelopmental outcomes at one year of age in children with gastroschisis were associated with being small for gestational age rather than the malformation.

The impact of surgery on the developmental status of late preterm infants - a cohort study.

AIMS: Despite increasing evidence in the literature regarding the impact of late prematurity on subsequent developmental impairment, the developmental outcome of late preterm infants who undergo major surgery remains unclear. The aim of this study therefore was to determine the developmental outcome for a cohort of late preterm surgical population. METHODS: Late preterm infants with a gestational age from 34-36 weeks inclusive who were enrolled in the state-wide prospective Development After Infant Surgery (DAISy) study and who had undergone non-cardiac major surgery within the first ninety days of life were eligible for inclusion. Infants were assessed at one and three years of ages. RESULTS: Forty-six infants were enrolled in the study, of which 38 infants had a complete developmental assessment at one year of age. Of these infants, late preterm infants scored significantly lower than the standardized norms of the assessment on the expressive language and gross motor subscales. At three years of age 26 infants were reassessed: late preterm infants who underwent major surgery only scored significantly lower than the standardized norms on the cognitive subscale (p less than 0.001). CONCLUSIONS: These data provide the evidence that late preterm infants who undergo major non-cardiac surgery are at risk of developmental impairment and consideration should be given to enrolling this cohort in multi-disciplinary developmental follow-up clinics.