Growth and neurodevelopmental outcome in newborns with congenital non-cardiac surgical anomalies: A single-centre retrospective study

• Published in: Journal of Pediatric Surgery Open Vol. 3; p. 100036
• Main Authors: Trivedi, Amit, Browning Carmo, Kathryn, James-Nunez, Kristen, Gordon, Adrienne
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2023; Elsevier
• Subjects: Congenital anomalies; Development; Growth; Neonates; Surgery; z-score birth weight; Neonates; birth weight; z-score head circumference at birth; Growth; length of stay in neonatal intensive care; Oesophageal atresia with or without trachea-oesophageal fistula; z-score head circumference at one-year-assessment; non-cardiac surgical anomalies; discharge weight; Surgery; Congenital anomalies; Development; congenital diaphragmatic hernia; socio-economic indexes for areas; head circumference; Bayley Scales of Infant and Toddler Development third edition; z-score discharge weight; z-score of weight at one-year-assessment
• ISSN: 2949-7116; 2949-7116
• DOI: 10.1016/j.yjpso.2023.100036

Survival of infants with congenital anomalies has increased dramatically, shifting the focus of clinical care and research toward optimising growth and neurodevelopment. To evaluate growth and determine the impact of growth on neurodevelopmental outcomes of neonates born at term gestation with congenital non-cardiac surgical anomalies (NCSA), who required a laparotomy. This was a single-centre retrospective cohort study. Demographic details, measurements of growth, and mean scores of Bayley Scales of Infant and Toddler Assessment, third edition, were collected. Means z-scores of growth measurements at birth, discharge and one-year-assessment were compared. Regression analysis was performed to explore predictive ability of growth measurements on mean scores of developmental assessment. A total of 105 infants were included. Mean z-scores for weight (-0.85) and head circumference (-0.34) at birth, though below population mean, were age-appropriate. Statistically significant decrease in z-score for weight was noted at discharge. Mean scores across the domains developmental assessment were normal. Z-scores for weight and height at one-year assessment predicted scores of gross motor (p-value 0.005) and cognitive development (p value 0.03) respectively. Neonates born at term gestation with NCSA had normal growth at birth. Postnatal growth restriction was noted at discharge. This loss in growth was not fully recouped at one-year assessment. As growth failure at one-year assessment could predict scores of developmental assessment, this group of infants needs careful nutritional and developmental monitoring.