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The impact of surgery on the developmental status of late preterm infants - a cohort study
Amit Trivedi1, Karen Walker2, Alison Loughran-Fowlds2
1Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Insights
Major surgery in late preterm infants (34-36 weeks gestation) is linked to developmental delays in expressive language, gross motor skills, and cognition. These infants require specialized developmental follow-up care.
Area of Science:
- Neonatal surgery outcomes
- Pediatric developmental assessment
- Preterm infant neurodevelopment
Background:
- Late preterm infants (34-36 weeks gestation) face developmental risks.
- The impact of major surgery on this population's development is not well understood.
Purpose of the Study:
- To evaluate the developmental outcomes of late preterm infants undergoing major non-cardiac surgery.
- To identify specific areas of developmental risk in this cohort.
Main Methods:
- Prospective enrollment in the Development After Infant Surgery (DAISy) study.
- Inclusion criteria: gestational age 34-36 weeks, major non-cardiac surgery within 90 days.
- Developmental assessments at 1 and 3 years of age.
Main Results:
- At 1 year, infants showed lower scores in expressive language and gross motor skills compared to norms.
- At 3 years, significant deficits were observed in cognitive development (p < 0.001).
Conclusions:
- Late preterm infants undergoing major surgery are at significant risk for developmental impairment.
- Multidisciplinary developmental follow-up is recommended for this high-risk group.
Aims:
Despite increasing evidence in the literature regarding the impact of late prematurity on subsequent developmental impairment, the developmental outcome of late preterm infants who undergo major surgery remains unclear. The aim of this study therefore was to determine the developmental outcome for a cohort of late preterm surgical population.
Methods:
Late preterm infants with a gestational age from 34-36 weeks inclusive who were enrolled in the state-wide prospective Development After Infant Surgery (DAISy) study and who had undergone non-cardiac major surgery within the first ninety days of life were eligible for inclusion. Infants were assessed at one and three years of ages.
Results:
Forty-six infants were enrolled in the study, of which 38 infants had a complete developmental assessment at one year of age. Of these infants, late preterm infants scored significantly lower than the standardized norms of the assessment on the expressive language and gross motor subscales. At three years of age 26 infants were reassessed: late preterm infants who underwent major surgery only scored significantly lower than the standardized norms on the cognitive subscale (p less than 0.001).
Conclusions:
These data provide the evidence that late preterm infants who undergo major non-cardiac surgery are at risk of developmental impairment and consideration should be given to enrolling this cohort in multi-disciplinary developmental follow-up clinics.
