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Neurocognitive outcomes in congenital diaphragmatic hernia survivors: a cross-sectional prospective study
Katarina Bojanić1, Marina Grubić2, Ana Bogdanić2
1Division of Neonatology, Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia.
Insights
Congenital diaphragmatic hernia (CDH) survivors show cognitive delays. Longer hospital stays correlate with lower neurocognitive scores, indicating a need for early interventions in CDH patients.
Area of Science:
- Pediatric Surgery
- Neurodevelopmental Pediatrics
- Congenital Anomalies
Background:
- Congenital diaphragmatic hernia (CDH) is a serious birth defect.
- Survivors of CDH may experience long-term neurodevelopmental challenges.
- Understanding cognitive outcomes in CDH survivors is crucial for improving care.
Purpose of the Study:
- To assess neurodevelopmental outcomes in congenital diaphragmatic hernia (CDH) survivors.
- To evaluate cognitive functioning from infancy through late teenage years.
- To identify factors associated with neurocognitive delays in CDH survivors.
Main Methods:
- A cross-sectional study involving 37 CDH survivors.
- Neurocognitive functioning assessed using Mullen Scales of Early Learning (ELC) and Wechsler Intelligence Scale for Children (FSIQ).
- Statistical analysis to compare scores with norms and identify associated factors.
Main Results:
- Early Learning Composite (ELC) scores were significantly lower than expected norms (P=0.004).
- Full Scale IQ (FSIQ) scores were consistent with norms (P=0.922), but moderate to severe delays were more frequent than expected (P=0.048).
- Longer hospital stay was the sole factor consistently linked to poorer cognitive scores.
Conclusions:
- A significant proportion of CDH survivors exhibit moderate to severe cognitive impairment.
- Early neurocognitive testing is recommended for CDH survivors.
- Timely therapeutic and educational interventions are essential for this population.
Background/Purpose:
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.
