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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcomes after neonatal surgery
Emily Lo1, Brian T Kalish2,3
1Division of Neonatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Insights
Neonatal surgery poses risks for long-term neurodevelopmental impairment (NDI) in children. This review examines surgery
Area of Science:
- Pediatric Surgery
- Neurodevelopmental Pediatrics
- Neonatal Medicine
Background:
- Neonatal surgery is associated with an increased risk of long-term neurodevelopmental impairment (NDI).
- Early surgical interventions during critical neurodevelopmental windows may lead to brain injury.
- NDI can manifest as motor delays, learning disabilities, executive dysfunction, and behavioral disorders, impacting quality of life.
Purpose of the Study:
- To review the existing literature on the effects of neonatal surgery on neurodevelopmental outcomes.
- To explore proposed mechanisms underlying surgery-induced neurodevelopmental challenges.
- To identify modifiable risk factors and patient groups benefiting from neurodevelopmental follow-up and early therapy.
Main Methods:
- Comprehensive literature review of studies investigating neonatal surgery and neurodevelopment.
- Analysis of proposed biological and physiological mechanisms impacting brain development post-surgery.
- Synthesis of findings to identify risk factors and therapeutic targets.
Main Results:
- Evidence suggests a link between neonatal surgery and adverse neurodevelopmental outcomes.
- Multiple mechanisms, including inflammation and altered brain connectivity, are implicated.
- Specific patient populations and surgical factors may increase NDI risk.
Conclusions:
- Neonatal surgery is a significant risk factor for neurodevelopmental impairment.
- Understanding underlying mechanisms is crucial for developing preventative strategies.
- Targeted neurodevelopmental follow-up and early intervention are vital for affected children.
Abstract:
Children who require surgery in the newborn period are at risk for long-term neurodevelopmental impairment (NDI). There is growing evidence that surgery during this critical window of neurodevelopment gives rise to an increased risk of brain injury, predisposing to neurodevelopmental challenges including motor delays, learning disabilities, executive function impairments, and behavioral disorders. These impairments can have a significant impact on the quality of life of these children and their families. This review explores the current literature surrounding the effect of neonatal surgery on neurodevelopment, as well as the spectrum of proposed mechanisms that may impact neurodevelopmental outcomes. The goal is to identify modifiable risk factors and patients who may benefit from close neurodevelopmental follow-up and early referral to therapy.
