Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation.
BACKGROUND
Information on physical and developmental outcomes of children with anatomical congenital anomalies (CAs) may indicate the need for early intervention and reduce impact on the child's life and parental burden.


METHODS
From 1999 to 2003, 101 children with CA (76.5% of initial survivors) were seen 6-monthly in a tertiary children's hospital. Growth, neurologic outcome, mental and psychomotor development as determined with the Bayley Scales of Infant Development, and categorization of predictive sociodemographic and medical variables of the children were evaluated prospectively and longitudinally.


RESULTS
Congenital diaphragmatic hernia (CDH) and esophageal atresia patients showed impaired growth, that is, both height for age (-1.5 standard deviation score [SDS]) and weight for height (-1.0 SDS). Overall neurologic outcome was normal, however, suspect or abnormal for 40% of CDH patients. Overall mental development was normal, but psychomotor scores were significantly lower than the norm (95% confidence interval, 83.8-92.2 at 6 months and 87.9-98.5 at 24 months). Sex, maternal age, socioeconomic status, CA, severity-of-disease covariables, and need of medical appliances at home could predict negative outcome significantly (P < .05).


CONCLUSIONS
The CA survivors show impaired growth and psychomotor developmental delay up to age 2 years. This warrants specific follow-up programs and infrastructure for these patients.
Gischler
Saskia J
SJ
Surgical Intensive Care Unit, Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
Mazer
Petra
P
Duivenvoorden
Hugo J
HJ
van Dijk
Monique
M
Bax
Nikolaas M A
NM
Hazebroek
Frans W J
FW
Tibboel
Dick
D
D002657:Child Development; D002675:Child, Preschool; D016001:Confidence Intervals; D000013:Congenital Abnormalities / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000379:methods*; D033183:Interdisciplinary Communication; D008297:Male; D011379:Prognosis; D011446:Prospective Studies