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Neurulation is the embryological process which forms the precursors of the central nervous system and occurs after gastrulation has established the three primary cell layers of the embryo: ectoderm, mesoderm, and endoderm. In humans, the majority of this system is formed via primary neurulation, in which the central portion of the ectoderm—originally appearing as a flat sheet of cells—folds upwards and inwards, sealing off to form a hollow neural tube. As development proceeds, the...
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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.

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Neonatal surgery poses risks for long-term neurodevelopmental impairment (NDI) in children. This review examines surgery

Keywords:
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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.