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Physical growth, neurodevelopment and cognition outcomes in children with abdominal wall defects: a tale with two endings?
  1. Karen Walker1,
  2. Andrew J A Holland2
  1. 1 Grace Centre for Newborn Care, The Children’s Hospital at Westmead, Cerebral Palsy Alliance, The University of Sydney, Sydney, New South Wales, Australia
  2. 2 Douglas Cohen Department of Paediatric Surgery, The Children’s Hospital at Westmead, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Karen Walker, Grace Centre for Newborn Intensive Care, The Children’s Hospital at Westmead, Cerebral Palsy Alliance, The University of Sydney, NSW 2145, Australia; karen.walker{at}health.nsw.gov.au

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The criteria for success have changed as survival for infants undergoing most major surgery for congenital anomalies has become ‘routine’, even in infants at younger gestations. With the current expectation of survival, the critical lens of assessment has now moved onto quality of life. Yet infants who undergo neonatal surgery for congenital anomalies are still known to be at risk of poor growth1 and neurodevelopmental delay: a recent meta-analysis that included 23 studies found that cognition and motor delay was identified in 23% of children.2 The neurodevelopmental outcomes of infants requiring surgery for abdominal wall defects (AWD) continue to be a focus for researchers, with differing outcomes reported in the literature.3–5 Studies assessing children in young infancy, such as Gupta et al,3 who reported the neurodevelopmental outcome at 1 year of age of 16 infants with gastroschisis (GS), found only neurodevelopmental delay in the language subsets in infants who were small for gestational age. Also reporting neurodevelopmental outcomes at 1 year of age, Minutillo et al 4 found a mean general quotient on the Griffiths developmental assessment of 99 (SD 9.8) in 88 infants with GS, a low incidence of developmental delay. At 2 years of age, Danzer and colleagues5 assessed 31 infants with a giant omphalocele, reporting a high incidence of neurological impairments in more than 50% of their cohort. More recent studies in later childhood are also not so reassuring, with working memory difficulties identified in a study by Harris et al 6 who assessed 39 children with GS at a mean age of 10 years. …

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