title: Psychosocial and cognitive consequences of major neonatal surgery.
abstract: OBJECTIVE
  To evaluate the long-term quality of life (QOL) of patients who had undergone major neonatal surgery, the psychosocial and cognitive consequences of neonatal surgical stress were assessed when the patients reached school age.
  
  
  METHODS
  Seventy-two patients who had undergone major neonatal surgery were enrolled in this study. Their primary diseases were anorectal malformation (ARM) in 27 cases, esophageal atresia (EA) in 23, and congenital diaphragmatic hernia (CDH) in 22. Intelligence tests using Wechsler Intelligence Scale for Children III (WISC-III) or a developmental test and the Child Behavior Checklist were conducted through questionnaires and interviews with clinical psychologists.
  
  
  RESULTS
  Mental retardation (MR) was apparent in 25% of EA, 20% of ARM, and 18% of CDH, significantly higher than the 2% to 3% commonly found in the general population. The clinical range (CR) of the Child Behavior Checklist was seen in 35% of EA, 59% of ARM, and 38% of CDH, which is also significantly higher than the 25% typically seen in the general population. No significant differences in MR and CR were seen among the primary diseases. The most important factors influencing MR and CR remain to be identified.
  
  
  CONCLUSIONS
  To ensure true quality of life after neonatal surgical stress, pediatric surgeons must consider not only physical assessments but also cognitive, emotional, and psychosocial assessments.
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. kubota@mch.pref.osaka.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Kubota
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nose
authors.forename: Etsuyo
authors.initials: E
authors.lastname: Yamamoto
authors.forename: Megumi
authors.initials: M
authors.lastname: Kosugi
authors.forename: Sakiko
authors.initials: S
authors.lastname: Yamakawa
authors.forename: Machiko
authors.initials: M
authors.lastname: Sawada
authors.forename: Shinya
authors.initials: S
authors.lastname: Hirano
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitajima
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoneda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakai
authors.forename: Keigo
authors.initials: K
authors.lastname: Nara
authors.forename: Taro
authors.initials: T
authors.lastname: Goda
authors.forename: Soji
authors.initials: S
authors.lastname: Ibuka
mesh_terms: D000293:Adolescent; D000359:Aftercare; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000209:etiology*; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D004065:Digestive System Abnormalities / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000523:psychology / Q000601:surgery*; D008607:Intellectual Disability / Q000453:epidemiology / Q000209:etiology*; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011584:Psychology; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D013514:Surgical Procedures, Operative / Q000523:psychology*