Developmental outcomes at 3 years of age following major non-cardiac and cardiac surgery in term infants: A population-based study

Karen Walker; Alison Loughran-Fowlds; Robert Halliday; Andrew J A Holland; Jan Stewart; Gary F Sholler; David S Winlaw; Nadia Badawi

doi:10.1111/jpc.12943

Developmental outcomes at 3 years of age following major non-cardiac and cardiac surgery in term infants: A population-based study

J Paediatr Child Health. 2015 Dec;51(12):1221-5. doi: 10.1111/jpc.12943. Epub 2015 Jun 17.

Authors

Karen Walker^{1

2}, Alison Loughran-Fowlds^{1

2}, Robert Halliday¹, Andrew J A Holland^{3

2}, Jan Stewart¹, Gary F Sholler^{4

2}, David S Winlaw^{4

2}, Nadia Badawi^{1

2

5}

Affiliations

¹ Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
² Discipline of Pediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
³ Douglas Cohen Department of Pediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
⁴ Heart Centre for Children, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
⁵ Notre Dame University, Sydney, New South Wales, Australia.

PMID: 26081460
DOI: 10.1111/jpc.12943

Abstract

Objective: The objective of this study was to determine whether there remain developmental differences between term infants at 3 years of age following major non-cardiac surgery (NCS) and cardiac surgery (CS) compared with healthy control infants in New South Wales (NSW), Australia.

Study design: Between 2006 and 2008, term infants who required NCS or CS within the first ninety days of life were enrolled in a prospective population-based study. Their developmental outcome was then compared with a cohort of healthy term infants. Infants initially assessed at 1 year of age were then re-assessed at 3 years of age using the Bayley scales of infant and toddler development (version-

Iii) results: Of the 539 term infants assessed at 1 year of age, 417 returned for the 3-year assessment, with 378 complete assessments. The mean scores for the infants who underwent CS (P < 0.001) were significantly lower in all subscales of the assessment compared with the controls, while the mean scores for the infants who underwent NCS were significantly lower in three of the subscales (P < 0.05). The infants who underwent CS scored significantly lower in four of the subscales (P < 0.05), compared with the infants who underwent NCS.

Conclusion: The second phase of this unique population-based study provides further data on the outcomes of infants who underwent major NCS and CS. Major surgery in infants continues to be associated with developmental delay at 3 years of age compared with control infants; however the majority of the delay is mild. The risk remains higher in CS group with the pattern and severity of delay similar to that observed in the first study.

Keywords: birth defect; cardiac surgery; developmental outcome; non-cardiac surgery.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Cardiac Surgical Procedures*
Child Development*
Child, Preschool
Developmental Disabilities / etiology*
Developmental Disabilities / physiopathology
Female
Humans
Infant
Infant, Newborn
Male
New South Wales
Prospective Studies
Treatment Outcome