Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.

Hdl Handle:
http://hdl.handle.net/10147/206233
Title:
Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.
Affiliation:
Department of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia;, Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Republic of Ireland.
Citation:
J Pediatr. 2011 Oct 31.
Journal:
The Journal of pediatrics
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206233
DOI:
10.1016/j.jpeds.2011.09.009
PubMed ID:
22048043
Abstract:
OBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.
Language:
ENG
ISSN:
1097-6833 (Electronic); 0022-3476 (Linking)

Full metadata record

DC FieldValue Language
dc.date.accessioned2012-01-31T16:44:04Z-
dc.date.available2012-01-31T16:44:04Z-
dc.date.issued2012-01-31T16:44:04Z-
dc.identifier.citationJ Pediatr. 2011 Oct 31.en_GB
dc.identifier.issn1097-6833 (Electronic)en_GB
dc.identifier.issn0022-3476 (Linking)en_GB
dc.identifier.pmid22048043en_GB
dc.identifier.doi10.1016/j.jpeds.2011.09.009en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206233-
dc.description.abstractOBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.en_GB
dc.language.isoENGen_GB
dc.titleNeurologic Outcomes in Very Preterm Infants Undergoing Surgery.en_GB
dc.contributor.departmentDepartment of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia;, Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Republic of Ireland.en_GB
dc.identifier.journalThe Journal of pediatricsen_GB
dc.description.provinceMunster-

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