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Growth trajectory and neurodevelopmental outcome in infants with congenital diaphragmatic hernia

Ryan M Antiel1, Nan Lin1, Daniel J Licht1

  • 1The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Journal of Pediatric Surgery
|October 29, 2017
PubMed

Insights

Congenital diaphragmatic hernia (CDH) survivors often experience mild developmental delays by one year. Impaired growth, particularly low head circumference trajectory, is linked to poorer neurodevelopmental outcomes in these infants.

Area of Science:

  • Pediatric Medicine
  • Developmental Pediatrics
  • Neonatology

Background:

  • Congenital diaphragmatic hernia (CDH) is a serious birth defect impacting lung development.
  • Neurodevelopmental (ND) outcomes in CDH survivors are a significant concern.
  • Early identification of factors influencing ND outcomes is crucial for timely intervention.

Purpose of the Study:

  • To assess the relationship between impaired growth and short-term neurodevelopmental outcomes in CDH survivors.
  • To identify specific growth parameters associated with developmental trajectories.
  • To evaluate the impact of neonatal intensive care unit (NICU) stay on neurodevelopment.

Main Methods:

  • Retrospective analysis of 84 CDH survivors assessed at 12 months using the Bayley Scales of Infant Development-III (BSID-III).
  • Group-based trajectory analysis to categorize growth patterns (weight, length, head circumference - HC).
  • Multivariate analysis to determine predictors of neurodevelopmental scores.

Main Results:

  • 51% of CDH survivors showed at least one mild developmental delay (1 SD below mean).
  • Lower cognitive scores correlated with longer NICU stays.
  • A 'high' head circumference (HC) trajectory group had significantly better motor scores compared to the 'low' HC group.

Conclusions:

  • Approximately half of CDH survivors exhibit mild developmental delays at one year of age.
  • Impaired head circumference growth trajectory is associated with worse neurodevelopmental outcomes.
  • Longer NICU stays negatively impact cognitive and motor development in CDH survivors.
Abstract

Keywords:
Bayley scales of infant developmentCongenital diaphragmatic herniaGrowth trajectoriesMalnutritionNeurodevelopmental outcome

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