title: Neurodevelopmental Outcomes After Neonatal Surgery for Major Noncardiac Anomalies.
abstract: BACKGROUND
  Increasing concerns have been raised about the incidence of neurodevelopmental delay in children with noncardiac congenital anomalies (NCCA) requiring neonatal surgery.
  
  
  OBJECTIVE
  This study aimed to determine the incidence and potential risk factors for developmental delay after neonatal surgery for major NCCA.
  
  
  METHODS
  A systematic search in PubMed, Embase and the Cochrane Library was performed through March 2015.
  
  
  METHODS
  Original research articles on standardized cognitive or motor skills tests.
  
  
  METHODS
  Data on neurodevelopmental outcome, the Bayley Scales of Infant Development, and risk factors for delay were extracted.
  
  
  RESULTS
  In total, 23 eligible studies were included, reporting on 895 children. Meta-analysis was performed with data of 511 children, assessed by the Bayley Scales of Infant Development at 12 and 24 months of age. Delay in cognitive development was reported in a median of 23% (3%-56%). Meta-analysis showed a cognitive score of 0.5 SD below the population average (Mental Development Index 92 ± 13, mean ± SD; P < .001). Motor development was delayed in 25% (0%-77%). Meta-analysis showed a motor score of 0.6 SD below average (Psychomotor Development Index 91 ± 14; P < .001). Several of these studies report risk factors for psychomotor delay, including low birth weight, a higher number of congenital anomalies, duration of hospital admission, and repeated surgery.
  
  
  CONCLUSIONS
  All data were retrieved from studies with small sample sizes and various congenital anomalies using different neurodevelopmental assessment tools.
  
  
  CONCLUSIONS
  Cognitive and motor developmental delay was found in 23% of patients with NCCA. Meta-analysis showed that the mean neurodevelopmental outcome scores were 0.5 SD below the normative score of the healthy population.
authors.affiliation: Paediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Brain Center Rudolf Magnus, University Medical Center, Utrecht l.j.stolwijk@umcutrecht.nl.
authors.forename: Lisanne J
authors.initials: LJ
authors.lastname: Stolwijk
authors.affiliation: Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
authors.forename: Petra Ma
authors.initials: PM
authors.lastname: Lemmers
authors.affiliation: Paediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
authors.forename: Marissa
authors.initials: M
authors.lastname: Harmsen
authors.affiliation: Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Brain Center Rudolf Magnus, University Medical Center, Utrecht.
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.affiliation: Paediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
authors.forename: David C
authors.initials: DC
authors.lastname: van der Zee
authors.affiliation: Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Brain Center Rudolf Magnus, University Medical Center, Utrecht.
authors.forename: Manon J N
authors.initials: MJ
authors.lastname: Benders
authors.affiliation: Paediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
authors.forename: Maud Y A
authors.initials: MY
authors.lastname: van Herwaarden-Lindeboom
mesh_terms: D000013:Congenital Abnormalities / Q000601:surgery*; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D015233:Models, Statistical; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors