Perinatal factors associated with poor neurocognitive outcome in early school age congenital diaphragmatic hernia survivors.

Published

Journal Article

OBJECTIVE: Determine predictors of neurocognitive outcome in early school age congenital diaphragmatic hernia (CDH) survivors. STUDY DESIGN: Prospective study of infants with CDH at Duke University Medical Center. Neurocognitive delay (NCD) at school age (4 to 7years) was defined as a score<80 in any of the following areas: Verbal Scale IQ, Performance Scale IQ, Expressive Language, or Receptive Language. Logistic regression, Fisher's exact, and the Wilcoxon rank sum test were used to examine the relationship between NCD at early school age and 6 demographic and 18 medical variables. RESULTS: Of 43 infants with CDH, twenty seven (63%) survived to hospital discharge, and 16 (59%) returned for school age testing at a median age of 4.9years. Seven (44%) of the children evaluated had NCD. Patch repair (p=0.01), extracorporeal membrane oxygenation (ECMO; p=0.02), days on ECMO (p=0.01), days of mechanical ventilation (p=0.049), and post-operative use of inhaled nitric oxide (p=0.02) were found to be associated with NCD at early school age. CONCLUSIONS: CDH survivors are at risk for neurocognitive delay persisting into school age. Perinatal factors such as patch repair and ECMO treatment may aid in identifying CDH survivors at high risk for continued learning difficulties throughout childhood.

Full Text

Duke Authors

Cited Authors

  • Benjamin, JR; Gustafson, KE; Smith, PB; Ellingsen, KM; Tompkins, KB; Goldberg, RN; Cotten, CM; Goldstein, RF

Published Date

  • April 2013

Published In

Volume / Issue

  • 48 / 4

Start / End Page

  • 730 - 737

PubMed ID

  • 23583126

Pubmed Central ID

  • 23583126

Electronic International Standard Serial Number (EISSN)

  • 1531-5037

Digital Object Identifier (DOI)

  • 10.1016/j.jpedsurg.2012.09.026

Language

  • eng

Conference Location

  • United States