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The Behavioral Problems in 2.5-5 Years Old Children Linked with Former Neonatal/Infantile Surgical Parameters

Danguolė Rugytė1, Giedrė Širvinskienė2,3, Rima Kregždytė4,5

  • 1Department of Anesthesiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

Children (Basel, Switzerland)
|June 2, 2021
PubMed

Insights

Major neonatal surgery may increase the risk of behavioral problems in children. Duration of mechanical ventilation and opioid doses were linked to externalizing problems, not cerebral oxygenation.

Area of Science:

  • Neonatal care
  • Pediatric surgery
  • Neurodevelopmental disorders

Background:

  • Neonatal surgery is associated with an increased risk of neurodevelopmental disorders.
  • Understanding the factors contributing to behavioral problems post-neonatal surgery is crucial.

Purpose of the Study:

  • To assess behavioral problem scores in young children (2.5-5 years) after major non-cardiac neonatal surgery.
  • To investigate the relationship between behavioral outcomes and intraoperative cerebral oxygenation, mechanical ventilation duration, and sedative/analgesic doses.

Main Methods:

  • Behavioral problems (internalizing and externalizing) were assessed using the Child Behavior Checklist (CBCL) in 34 children.
  • Data on intraoperative cerebral tissue oxygenation (rSO2), duration of mechanical ventilation (DMV), and medication doses were collected.
  • Statistical analyses were performed to identify predictors of behavioral problems.

Main Results:

  • No correlation was found between intraoperative rSO2 and behavioral problem scores.
  • DMV was found to be predictive of externalizing problems (EP).
  • Opioid dose per day of ventilation was a significant predictor of EP, even after adjusting for gestational age, assessment age, surgery age, and benzodiazepine dose.

Conclusions:

  • Intraoperative cerebral oxygenation in neonates is not associated with later behavioral problems.
  • Duration of mechanical ventilation and opioid exposure are potential risk factors for externalizing problems in children following neonatal surgery.
  • Risk factors for externalizing problems in this cohort resemble those observed in preterm infants.

Keywords:
cerebral tissue oxygenationchild behavior checklistexternalizing problemsinfantsinternalizing problemsnear infrared spectroscopyneonatessurgery

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