Motor and cognitive outcome at school age of children with surgically treated intestinal obstructions in the neonatal period.

BACKGROUND: The motor and cognitive outcome at school age of newborn children with surgically treated intestinal obstructions is unknown. Physiological stress and anesthesia may potentially be harmful in the period of early brain development in newborn infants.

OBJECTIVE: To determine motor and cognitive outcome at school age in children with surgically treated intestinal obstructions as newborns, and to identify clinical risk factors for adverse outcome.

STUDY DESIGN: Cohort study of infants born between 1995 and 2002 with atresia, stenosis, or intestinal malrotation. At 6 to 13years we assessed their motor functions, intelligence, attention, visual perception, visuomotor integration, and verbal memory.

RESULTS: Of 44 children three (7%) died. Twenty-seven survivors (66%) were included for follow-up (median gestational age 36.7weeks, birth weight 3000g). Motor outcome was abnormal (<5th percentile) in 22% of the children, which was significantly more than in the norm population (P<0.01). Scores on selective attention were abnormal in 15% of the children (P<0.01). Other cognitive functions were not affected. Lower birth weight and intestinal perforation were risk factors for poorer motor outcome (R(2)=53.0%), intrauterine growth restriction was a risk factor for poorer selective attention (R(2)=36.6%).

CONCLUSIONS: Children treated surgically for intestinal obstructions in the neonatal period had an increased risk for poor motor functioning and selective attention at school age. Low birth weight, intrauterine growth restriction and intestinal perforation were risk factors for adverse outcome. We recommend to closely follow the motor and attentional development of these children.