AffiliationDepartment of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia;, Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Republic of Ireland.
MetadataShow full item record
CitationJ Pediatr. 2011 Oct 31.
JournalThe Journal of pediatrics
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.
- Consequences of delayed surgical closure of patent ductus arteriosus in very premature infants.
- Authors: Jaillard S, Larrue B, Rakza T, Magnenant E, Warembourg H, Storme L
- Issue date: 2006 Jan
- Defining the nature of the cerebral abnormalities in the premature infant: a qualitative magnetic resonance imaging study.
- Authors: Inder TE, Wells SJ, Mogridge NB, Spencer C, Volpe JJ
- Issue date: 2003 Aug
- Head growth in preterm infants: correlation with magnetic resonance imaging and neurodevelopmental outcome.
- Authors: Cheong JL, Hunt RW, Anderson PJ, Howard K, Thompson DK, Wang HX, Bear MJ, Inder TE, Doyle LW
- Issue date: 2008 Jun
- Uncomplicated intraventricular hemorrhage is followed by reduced cortical volume at near-term age.
- Authors: Vasileiadis GT, Gelman N, Han VK, Williams LA, Mann R, Bureau Y, Thompson RT
- Issue date: 2004 Sep
- Abnormal cerebral structure is present at term in premature infants.
- Authors: Inder TE, Warfield SK, Wang H, Hüppi PS, Volpe JJ
- Issue date: 2005 Feb