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  • Title: Growth trajectory and neurodevelopmental outcome in infants with congenital diaphragmatic hernia.
    Author: Antiel RM, Lin N, Licht DJ, Hoffman C, Waqar L, Xiao R, Monos S, D'Agostino JA, Bernbaum J, Herkert LM, Rintoul NE, Peranteau WH, Flake AW, Adzick NS, Hedrick HL.
    Journal: J Pediatr Surg; 2017 Dec; 52(12):1944-1948. PubMed ID: 29079316.
    Abstract:
    PURPOSE: The purpose of this study was to evaluate the impact of impaired growth on short-term neurodevelopmental (ND) outcomes in CDH survivors. METHODS: Between 9/2005-12/2014, 84 of 215 (39%) CDH survivors underwent ND assessment at 12months of age using the BSID-III. RESULTS: Mean cognitive, language, and motor scores were 92.6±13.5, 87.1±11.6, and 87.0±14.4, respectively (normal 100±15). 51% of patients scored 1 SD below the population mean in at least one domain, and 13% scored 2 SD below the population mean. Group-based trajectory analysis identified two trajectory groups ('high' and 'low') for weight, length, and head circumference (HC) z-scores. (Fig. 1) 74% of the subjects were assigned to the 'high' trajectory group for weight, 77% to the 'high' height group, and 87% to the 'high' HC group, respectively. In multivariate analysis, longer NICU stay (p<0.01) was associated with lower cognitive scores. Motor scores were 11 points higher in the 'high' HC group compared to the 'low' HC group (p=0.05). Motor scores were lower in patients with longer NICU length of stay (p<0.001). CONCLUSIONS: At 1 year, half of CDH survivors had a mild delay in at least one developmental domain. Low HC trajectory was associated with worse neurodevelopmental outcomes. TYPE OF STUDY: Prognosis Study/Retrospective Study. LEVEL OF EVIDENCE: Level II.
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