Short-Term Neurodevelopmental Outcome in Children Born With High-Risk Congenital Lung Lesions.
Ann Thorac Surg. 2018 Feb 10;:
Authors: Danzer E, Hoffman C, D’Agostino JA, Boelig MM, Gerdes M, Bernbaum JC, Rosenthal H, Waqar LN, Rintoul NE, Herkert LM, Kallan MJ, Peranteau WH, Flake AW, Adzick NS, Hedrick HL
BACKGROUND: To evaluate neurodevelopmental outcome in high-risk congenital lung lesions (CLLs) survivors who underwent prenatal intervention or postnatal surgery within the first month of life.
METHODS: Forty-five high-risk CLLs survivors underwent assessment using the Bayley Scales of Infant Development, 3rd Edition between 07/2004 and 12/2016. Scores were grouped as average, at-risk, and delayed based on standard deviation intervals. Correlations between outcome and risk factors were analyzed by Fisher’s exact test or two-sided t-test as appropriate, with significant p-values <0.05.
RESULTS: Open prenatal intervention was required in 13 (28.9%) children (fetal surgery resection, n=4 , ex utero intrapartum treatment, n=9), while 32 (71.1%) developed respiratory distress postnatally necessitating resection within the first month of life. Mean age at follow-up was 19.3±10.3 months. Mean composite scores were within the expected average range. A total of 62.2% scored within the average range for all domains. At-risk scores were found in 26.7% in at least one domain, and 11.1% had delays in at least one domain. Neurodevelopmental outcome was similar between treatment groups. Prolonged ventilator support and NICU stay, need for supplemental oxygen at day of life 30, gastroesophageal reflux disease, and delayed enteral feeding were associated with neurological delays (all p<0.05).
CONCLUSIONS: Neurodevelopmental scores for high-risk CLLs survivors in infancy and toddlerhood are age appropriate. Neither fetal intervention nor the need for postnatal resection within the first moth of life increases the risk of delays. Surrogate markers of a complicated neonatal course are predictive of adverse outcome.
PMID: 29438655 [PubMed – as supplied by publisher]