title: Early developmental outcomes following major noncardiac and cardiac surgery in term infants: a population-based study.
abstract: OBJECTIVE
  To ascertain developmental differences between term infants after major noncardiac surgery and cardiac surgery compared with healthy control infants in New South Wales, Australia.
  
  
  METHODS
  This prospective population-based cohort study enrolled infants between August 1, 2006, and December 31, 2008, who required major noncardiac surgery within the first 90 days of life. Developmental outcomes were compared in these children, cohorts of term infants requiring cardiac surgery, and healthy controls. Infants were assessed at 1 year of age using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III).
  
  
  RESULTS
  Of the 784 infants enrolled, 688 (90.2%) of infants alive at 1 year were assessed. Of these, 539 infants were term and were included in the present analysis. Compared with controls, the infants who underwent cardiac surgery had significantly lower (P < .001) mean scores in all 5 BSID-III subscales, and the infants who underwent noncardiac surgery had significantly lower (P < .05) mean scores in 4 of the 5 BSID-III subscales. The greatest difference was in the incidence of gross motor delay in both the cardiac surgery group (OR, 0.25; 95% CI, 0.16-0.41) and the noncardiac surgery group (OR, 0.41; 95% CI, 0.26-0.63).
  
  
  CONCLUSIONS
  This unique population-based prospective study compared the developmental outcomes of infants who underwent major noncardiac surgery and cardiac surgery. Major surgery in infants was found to be significantly associated with developmental delay at 1 year of age compared with control infants. These data have important implications for interventions and clinical review in the first year of life.
authors.affiliation: Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. karen.walker@health.nsw.gov.au
authors.forename: Karen
authors.initials: K
authors.lastname: Walker
authors.forename: Nadia
authors.initials: N
authors.lastname: Badawi
authors.forename: Robert
authors.initials: R
authors.lastname: Halliday
authors.forename: Jan
authors.initials: J
authors.lastname: Stewart
authors.forename: Gary F
authors.initials: GF
authors.lastname: Sholler
authors.forename: David S
authors.initials: DS
authors.lastname: Winlaw
authors.forename: Megan
authors.initials: M
authors.lastname: Sherwood
authors.forename: Andrew J A
authors.initials: AJ
authors.lastname: Holland
mesh_terms: D006348:Cardiac Surgical Procedures; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013514:Surgical Procedures, Operative