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State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation
Saskia J Gischler1, Petra Mazer, Hugo J Duivenvoorden
1Surgical Intensive Care Unit, Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
Insights
Children with congenital anomalies (CAs) experience impaired growth and psychomotor delays up to age two. Early intervention and specialized follow-up programs are crucial for improving outcomes in these pediatric patients.
Area of Science:
- Pediatric Medicine
- Developmental Pediatrics
- Congenital Anomalies Research
Background:
- Congenital anomalies (CAs) significantly impact child development and parental well-being.
- Early intervention strategies are vital for mitigating the long-term effects of CAs.
Purpose of the Study:
- To prospectively evaluate the physical and developmental outcomes of children with CAs.
- To identify predictive factors for negative outcomes in pediatric CA survivors.
Main Methods:
- Longitudinal follow-up of 101 children with CAs over 5 years.
- Assessment of growth, neurologic, and developmental (Bayley Scales) outcomes.
- Analysis of sociodemographic and medical variables predicting outcomes.
Main Results:
- Congenital diaphragmatic hernia (CDH) and esophageal atresia patients exhibited impaired growth (height and weight).
- While overall neurologic and mental development was normal, 40% of CDH patients had abnormal neurologic outcomes.
- Psychomotor development scores were significantly lower than norms up to 24 months.
Conclusions:
- Pediatric CA survivors demonstrate persistent impaired growth and psychomotor developmental delay up to age two.
- Specific follow-up programs and dedicated infrastructure are necessary for managing CA survivors.
- Sociodemographic and medical factors predict negative outcomes, highlighting the need for targeted support.
Background:
Information on physical and developmental outcomes of children with anatomical congenital anomalies (CAs) may indicate the need for early intervention and reduce impact on the child's life and parental burden.
Methods:
From 1999 to 2003, 101 children with CA (76.5% of initial survivors) were seen 6-monthly in a tertiary children's hospital. Growth, neurologic outcome, mental and psychomotor development as determined with the Bayley Scales of Infant Development, and categorization of predictive sociodemographic and medical variables of the children were evaluated prospectively and longitudinally.
Results:
Congenital diaphragmatic hernia (CDH) and esophageal atresia patients showed impaired growth, that is, both height for age (-1.5 standard deviation score [SDS]) and weight for height (-1.0 SDS). Overall neurologic outcome was normal, however, suspect or abnormal for 40% of CDH patients. Overall mental development was normal, but psychomotor scores were significantly lower than the norm (95% confidence interval, 83.8-92.2 at 6 months and 87.9-98.5 at 24 months). Sex, maternal age, socioeconomic status, CA, severity-of-disease covariables, and need of medical appliances at home could predict negative outcome significantly (P < .05).
Conclusions:
The CA survivors show impaired growth and psychomotor developmental delay up to age 2 years. This warrants specific follow-up programs and infrastructure for these patients.
