Related Experiment Video
Updated: May 22, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early neurodevelopmental outcome of infants with high-risk fetal lung lesions
Enrico Danzer1, Jennifer Siegle, Jo Ann D'Agostino
1The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, Pa. 19104, USA.
Insights
Most infants with high-risk fetal lung lesions requiring intervention show age-appropriate neurodevelopmental outcomes. Follow-up assessments indicate average cognitive, language, and neuromotor skills in the majority of these children.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Developmental Pediatrics
Background:
- High-risk fetal lung lesions pose significant challenges to infant survival and development.
- Interventions, including fetal surgery and ex utero intrapartum therapy (EXIT), are employed for severe cases.
- Postnatal respiratory distress necessitates emergent surgical resection in some infants.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of infants diagnosed with high-risk fetal lung lesions.
- To evaluate developmental trajectories in infants requiring prenatal intervention or immediate postnatal surgery.
Main Methods:
- Retrospective review of 13 consecutive patients in a prospective follow-up program.
- Neurodevelopmental assessment using Bayley Scales of Infant Development-III (≤3 years) and Wechsler Preschool and Primary Scale of Intelligence-III (≥4 years).
Main Results:
- Majority of children (62%) underwent prenatal intervention; 38% required postnatal resection.
- Children under 3 years generally had average cognitive scores; one 6-year-old scored borderline.
- Most children demonstrated average language (54%) and neuromotor (77%) outcomes, with some mild deficits; no severe delays were observed.
Conclusions:
- The majority of infants with high-risk fetal lung lesions achieve age-appropriate neurodevelopmental scores.
- Early intervention and management strategies appear to support positive developmental outcomes.
- Further research may explore long-term neurodevelopmental trajectories and specific risk factors.
Objective:
To evaluate the neurodevelopmental outcome of infants with high-risk fetal lung lesions defined as (1) requiring fetal intervention and/or ex utero intrapartum therapy (EXIT), or (2) acute respiratory decompensation postnatally necessitating emergent resection within 48 h of life.
Methods:
We reviewed the medical records of 13 consecutive patients with high-risk fetal lung lesions who were enrolled in our prospective interdisciplinary follow-up program. Neurodevelopmental status was evaluated using the Bayley Scales of Infant Development-III (children ≤3 years, n = 12), or the Wechsler Preschool and Primary Scale of Intelligence-III (children ≥4 years, n = 1).
Results:
Eight children (62%) underwent prenatal intervention (EXIT, n = 6; fetal resection, n = 1; intrauterine shunt placement, n = 1), and 5 (38%) required emergent resection postnatally. Median age at evaluation was 25 months (range: 5-80). Average scores for cognitive development were found in all children assessed under 3 years of age. The one child who was tested for cognitive ability at 6 years of age scored in the borderline range of intellectual functioning. For language outcome, 15% scored above average, 54% scored within the average range, and 31% had mild deficits. Overall, 77% scored within the average range for neuromotor outcome, while 23% scored within the mildly delayed range. None of the children had severe delays. Cognitive, language, and psychomotor scores were similar between both groups. Hypotonicity was found in 23%. Autism was suspected in one child who underwent an EXIT procedure and was postnatally diagnosed with mosaic trisomy 18.
Conclusion:
The majority of children with high-risk fetal lung lesions have age-appropriate neurodevelopmental scores.
More Related Videos
07:36Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019