Motor-function and exercise capacity in children with major anatomical congenital anomalies: An evaluation at 5years of age

Abstract

Children with major anatomical CA and especially those with CDH and EA are at risk for delayed motor-function and disturbed exercise capacity.

Neurodevelopmental Outcomes After Neonatal Surgery for Major Noncardiac Anomalies

“…After screening of title/abstract followed by full text, 23 papers 6,7,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] reporting on 895 children met our inclusion and exclusion criteria and were selected for systematic review (Table 1). There was a wide range in follow-up duration and time of assessment from 12 months up to 60 months of age.…”

“…As a result of small patient numbers, authors chose to pool different congenital malformations that shared a requirement for neonatal surgery. 6,7,30,37 Second, parameters that may influence neurodevelopmental outcome, such as gestational age, 28 duration of hospital admission, 7,26,28,40 and repeat surgery, 6,7,29,30 varied within and among patient cohorts.…”

“…In 1 study, the motor development of 102 children with NCCA was investigated with the M-ABC at a mean age of 5.7 years. 30 A delay in motor development (<1 SD) was found in 29% of those with NCCA. Most of these patients had CDH or esophageal atresia, and a significant correlation with repeat surgery was found.…”

“…A higher number of congenital anomalies also significantly increased the risk of neurodevelopmental delay. 7,30,37 Neuroimaging with either cerebral ultrasonography, CT, or MRI scanning was reported in 11 studies, 7,26,27,31,34,35,[40][41][42]45,47 and 10 of these articles reported solely on CDH. In 7 studies, 7,34,[40][41][42]45,47 the correlation between brain damage and neurodevelopmental outcome was not explored, and in 4 studies, 26,27,31,35 no significant correlation was found.…”

“…7,26,28,37,40 A higher number of surgical interventions was found to be correlated with a lower cognitive and motor outcome. 6,7,29,30,37 Duration of mechanical ventilation 29,31,35,37,40,42 and the need for supplemental oxygen at discharge 26 were both reported as risk factors for neurodevelopmental delay.…”