Leigh Dueck & Kelly Sutton

Neurodevelopmental Outcomes of Children with Congenital Diaphragmatic Hernia

Authors: Kelly Sutton, Leigh Dueck, Margot Mackay, Dr. Julie Petrie, Anne Synnes, & Dr. Jill Zwicker

Rationale. Congenital diaphragmatic hernia (CDH) is a rare birth defect resulting in incomplete diaphragm formation during fetal development; abdominal organs herniate into the chest cavity and hinder lung development. Respiratory deficiencies at birth contribute to poor neonatal outcomes, but few studies have extensively examined neurodevelopmental outcomes of children with CDH. Objectives. The aims of this study are to describe the motor and global cognitive outcomes of children born with CDH and determine whether severity of CDH is associated with poorer neurodevelopmental outcomes. Children classified as high risk are defined as having had patch repair, extracorporeal membrane oxygenation, and/or respiratory support ≥ 30 days. Methods. Neurodevelopment of 66 children with CDH at 4.5 years was assessed at a neonatal follow-up program at a tertiary care hospital. Motor development was assessed using the Movement Assessment Battery for Children and the Peabody Developmental Motor Scales. Global cognitive development was assessed using the Wechsler Preschool and Primary Scale of Intelligence. Frequencies and descriptive statistics were used to describe our cohort’s motor and cognitive performance. Chi squared analyses were used to compare the proportion of high vs. low risk children who scored within a low or average range. Results. The majority of children scored within an average range on both motor and global cognitive outcome measures at 4.5 years. A high risk classification was not significantly associated with poorer neurodevelopmental outcomes at 4.5 years. Conclusion. Further studies are needed to identify guidelines for neurodevelopmental screening for children with CDH.