کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3917000 1252087 2015 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Patient characteristics are important determinants of neurodevelopmental outcome during infancy in giant omphalocele
ترجمه فارسی عنوان
ویژگی های بیمار تعیین کننده های مهمی در نتیجه ی پیشرفت های عصبی در دوران پس از زایمان در اوگاندا است
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
چکیده انگلیسی


• Short-term neurological impairments are present in more than half of GO survivors.
• Surrogate markers of pulmonary hypoplasia and hypertension, and failure to thrive predicting neurological dysfunction.
• Autism and hypotonicity were often co-morbidities with neurodevelopmental delays and poor motor function.
• Preschool and school age outcomes are necessary to further understand the natural history of adverse outcome in GO children.

ObjectiveTo examine patient-specific factors as potential predictors of neurodevelopmental (ND) outcome in children with giant omphalocele (GO).MaterialsBetween 06/2005 and 07/2012, 31 consecutive GO survivors underwent ND assessment using the BSID-III at a median of 24 months (range 6–35). ND delay was defined by a score of ≤ 84 in any composite score. Severe impairments were defined as a score of ≤ 69 in at least one domain. Correlations between ND outcome and patient-specific factors were analyzed by one-way ANOVA, chi-square, or logistic regression as appropriate.ResultsThe mean cognitive score (86.8 ± 16.8) was in the low average range. Mean language (83.2 ± 21.1) and motor (81.5 ± 16.2) scores were below average. Forty-six-percent scored within the average range for all scales. Mild deficits were found in 19%, and 35% had severe delays in at least one domain. Hypotonicity was present in 55%. Autism was suspected/confirmed in 13%. Predictors of lower ND scores were prolonged ventilator support (P < 0.01), high-frequency oscillatory ventilation (P < 0.01), tracheostomy placement (P < 0.001), O2 supplementation at day of life 30 (P < 0.02), pulmonary hypertension (P < 0.02), delayed enteral feeding (P = 0.01), need for feeding tube (P < 0.001), GERD (P = 0.05), abnormal BAER hearing screen (P < 0.006), prolonged hospitalization (P = 0.01), and failure to thrive (P = 0.001). Autism was associated with delays in cognitive and language outcomes (P < 0.03). Delayed staged closure (P = 0.007), older age at final repair (P = 0.03), and hypotonicity (P = 0.02) were associated with motor dysfunction.ConclusionsNeurological impairments were present in more than half of GO survivors. Disease severity was associated with ND dysfunction. Autism and hypotonicity were often co-morbidities with ND delays and poor motor function.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Early Human Development - Volume 91, Issue 3, March 2015, Pages 187–193
نویسندگان
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