title: Developmental outcomes and physical activity behaviour in children post major surgery: an observational study.
abstract: Infants may be at neurodevelopmental risk from adverse events arising in the neonatal period. This study aimed to investigate the developmental outcomes and physical activity behaviours of term infants after neonatal major surgery, at age three years.
  
  
  
  This prospective study enrolled infants who underwent major surgery in their first 90 days, between August 2006 and December 2008. Developmental status was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Physical activity and sedentary behaviour (i.e. small screen recreation) (SSR) were assessed using the Preschool-Age Physical Activity Questionnaire (Pre-PAQ). Activity (moving between slow to fast pace) and SSR were reported for a 3-day period.
  
  
  
  One hundred and thirty five children (68 major surgery, 67 control) were assessed, using both measures, at age three years. Both groups were within the average range across all domains of the BSID-III although the surgical group was significantly below the controls for cognition (t = -3.162, p = 0.002) receptive language (t = -3.790, p < 0.001) and fine motor skills (t = -2.153, p = 0.03). Mean activity time for the surgical group was 191 mins.day(-1), and 185 mins.day-1 for controls. Mean SSR time was 77 mins.day(-1), and 83 mins.day(-1) for the respective groups. There was no significant difference between groups for either physical activity (p = 0.71) or SSR time (p = 0.49).
  
  
  
  By age three, children who had major surgery in infancy are developmentally normal but have not quite caught up with their peer group in cognitive, receptive language and fine motor skill domains. Both groups met recommended 3 h of daily physical activity but exceeded 60-min SSR time recommended for preschool-age children.
authors.affiliation: Physiotherapy Program, School of Science and Health, The University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Sydney, Australia. g.dwyer@westernsydney.edu.au.
authors.forename: Genevieve Mary
authors.initials: GM
authors.lastname: Dwyer
authors.affiliation: Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, Australia.|Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Walker
authors.affiliation: Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Baur
authors.affiliation: Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, Australia.|Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Badawi
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009048:Motor Skills; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies
keywords: Bayley Scale of Infant and Toddler Development, Third edition; Child; Cognitive; Developmental outcomes; Early childhood; Follow-up; Infant; Language development; Motor; Neonatal surgery; Neurodevelopment; Physical activity behaviour; Preschool-Age Physical Activity Questionnaire; Sedentary behaviour; Small screen recreation