title: Neurocognitive outcomes in congenital diaphragmatic hernia survivors: a cross-sectional prospective study.
abstract: OBJECTIVE
  Congenital diaphragmatic hernia (CDH) survivors may have persistent neurocognitive delays. We assessed neurodevelopmental outcomes in CDH survivors from infancy to late teenage years.
  
  
  METHODS
  A cross-sectional study was conducted on 37 CDH survivors to examine neurocognitive functioning. Overall cognitive score was tested with the early learning composite (ELC) of Mullen Scales of Early Learning (n=19), and Full Scale IQ (FSIQ) of Wechsler Intelligence Scale for Children-Fourth Edition (n=18).
  
  
  RESULTS
  ELC was 85.7±16.4, lower than the expected norm of 100, P=0.004, and 6 survivors had moderate, and 3 severe delay, which is not greater than expected in the general population (P=0.148). FSIQ was 99.6±19.1, consistent with the expected norm of 100, P=0.922, and 3 survivors had moderate and 2 severe delay, which is greater than expected (P=0.048). Although ELC was lower than FSIQ (P=0.024), within each testing group overall cognitive ability was not associated with participant age (ELC, P=0.732; FSIQ, P=0.909). Longer hospital stay was the only factor found to be consistently associated with a worse cognitive score across all participants in our cohort.
  
  
  CONCLUSIONS
  A high percentage of survivors with CDH have moderate to severe cognitive impairment suggesting that these subjects warrant early testing with implementation of therapeutic and educational interventions.
authors: Division of Neonatology, Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia.
authors: Katarina
authors: K
authors: Bojanić
authors: Department of Pediatrics, University of Zagreb, School of Medicine, University Hospital Centre Zagreb, Croatia.
authors: Marina
authors: M
authors: Grubić
authors: Department of Pediatrics, University of Zagreb, School of Medicine, University Hospital Centre Zagreb, Croatia.
authors: Ana
authors: A
authors: Bogdanić
authors: Department of Pediatrics, University of Zagreb, School of Medicine, University Hospital Centre Zagreb, Croatia.
authors: Jurica
authors: J
authors: Vuković
authors: Mayo Clinic, Rochester, MN, USA.
authors: Toby N
authors: TN
authors: Weingarten
authors: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
authors: Andrea R
authors: AR
authors: Huebner
authors: Mayo Clinic, Rochester, MN, USA. Electronic address: sprung.juraj@mayo.edu.
authors: Juraj
authors: J
authors: Sprung
authors: Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic, Rochester, MN, USA.
authors: Darrell R
authors: DR
authors: Schroeder
authors: Department of Pediatrics, University of Zagreb, School of Medicine, University Hospital Centre Zagreb, Croatia.
authors: Ruža
authors: R
authors: Grizelj
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications*; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000175:diagnosis / Q000209:etiology*; D007361:Intelligence Tests; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D017741:Survivors
keywords: Congenital diaphragmatic hernia; Cross-sectional study; Early learning composite score, ELC; Full scale IQ, FSIQ; Mullen Scales of Early Learning, MSEL; Wechsler Intelligence Scale–Fourth Edition, WISC-IV