Skip to main content
Top
Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

Developmental outcomes and physical activity behaviour in children post major surgery: an observational study

Authors: Genevieve Mary Dwyer, Karen Walker, Louise Baur, Nadia Badawi

Published in: BMC Pediatrics | Issue 1/2016

Login to get access

Abstract

Background

Infants may be at neurodevelopmental risk from adverse events arising in the neonatal period. This study aimed to investigate the developmental outcomes and physical activity behaviours of term infants after neonatal major surgery, at age three years.

Methods

This prospective study enrolled infants who underwent major surgery in their first 90 days, between August 2006 and December 2008. Developmental status was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Physical activity and sedentary behaviour (i.e. small screen recreation) (SSR) were assessed using the Preschool-Age Physical Activity Questionnaire (Pre-PAQ). Activity (moving between slow to fast pace) and SSR were reported for a 3-day period.

Results

One hundred and thirty five children (68 major surgery, 67 control) were assessed, using both measures, at age three years. Both groups were within the average range across all domains of the BSID-III although the surgical group was significantly below the controls for cognition (t = −3.162, p = 0.002) receptive language (t = −3.790, p < 0.001) and fine motor skills (t = −2.153, p = 0.03). Mean activity time for the surgical group was 191 mins.day−1, and 185 mins.day-1 for controls. Mean SSR time was 77 mins.day−1, and 83 mins.day−1 for the respective groups. There was no significant difference between groups for either physical activity (p = 0.71) or SSR time (p = 0.49).

Conclusions

By age three, children who had major surgery in infancy are developmentally normal but have not quite caught up with their peer group in cognitive, receptive language and fine motor skill domains. Both groups met recommended 3 h of daily physical activity but exceeded 60-min SSR time recommended for preschool-age children.
Literature
1.
go back to reference Hack M, Klein NK, Taylor HG. Long-term developmental outcomes of low birth weight infants. Future children. 1995;5:176–96.CrossRef Hack M, Klein NK, Taylor HG. Long-term developmental outcomes of low birth weight infants. Future children. 1995;5:176–96.CrossRef
2.
go back to reference Hack M, Klein NK, Taylor HG. Predictors of developmental outcomes for medically fragile early intervention participants. J Pediatr Psychol. 1996;21:869–87.CrossRef Hack M, Klein NK, Taylor HG. Predictors of developmental outcomes for medically fragile early intervention participants. J Pediatr Psychol. 1996;21:869–87.CrossRef
3.
go back to reference Singer L, Yamashita T, Lilien L, Collin M, Baley J. A longitudinal study of developmental outcome of infants with bronchopulmonary dysplasia and very low birth weight. Pediatrics. 1997;100:987–93.CrossRefPubMedPubMedCentral Singer L, Yamashita T, Lilien L, Collin M, Baley J. A longitudinal study of developmental outcome of infants with bronchopulmonary dysplasia and very low birth weight. Pediatrics. 1997;100:987–93.CrossRefPubMedPubMedCentral
4.
go back to reference Aylward GP. Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2014;35:394–407.CrossRefPubMed Aylward GP. Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2014;35:394–407.CrossRefPubMed
5.
go back to reference Gischler SJ, Mazer P, Duivenvoorden HJ, van Dijk M, Bax NMA, Hazebroek FWJ, et al. Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation. J Pediatr Surg. 2009;44:1382–9.CrossRefPubMed Gischler SJ, Mazer P, Duivenvoorden HJ, van Dijk M, Bax NMA, Hazebroek FWJ, et al. Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation. J Pediatr Surg. 2009;44:1382–9.CrossRefPubMed
6.
go back to reference McGrath E, Wypij D, Rappaport LA, Newburger JW, Bellinger DC. Prediction of IQ and achievement at age 8 years from neurodevelopmental status at age 1 year in children with D-transposition of the great arteries. Pediatrics. 2004;114:e572–6.CrossRefPubMed McGrath E, Wypij D, Rappaport LA, Newburger JW, Bellinger DC. Prediction of IQ and achievement at age 8 years from neurodevelopmental status at age 1 year in children with D-transposition of the great arteries. Pediatrics. 2004;114:e572–6.CrossRefPubMed
7.
go back to reference Majnemer A, Limperopoulos C, Shevell MI, Rohlicek C, Rosenblatt B, Tchervenkov C. A new look at outcomes of infants with congenital heart disease. Pediatr Neurol. 2009;40:197–204.CrossRefPubMed Majnemer A, Limperopoulos C, Shevell MI, Rohlicek C, Rosenblatt B, Tchervenkov C. A new look at outcomes of infants with congenital heart disease. Pediatr Neurol. 2009;40:197–204.CrossRefPubMed
8.
go back to reference Snookes SH, Gunn JK, Eldridge BJ, Donath SM, Hunt RW, Galea MP, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics. 2010;125:e818–27.CrossRefPubMed Snookes SH, Gunn JK, Eldridge BJ, Donath SM, Hunt RW, Galea MP, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics. 2010;125:e818–27.CrossRefPubMed
9.
go back to reference Long SH, Galea MP, Eldridge BJ, Harris SR. Performance of 2-year-old children after early surgery for congenital heart disease on the Bayley Scales of Infant and Toddler Development, Third Edition. Early Hum Dev. 2012;88:603–7.CrossRefPubMed Long SH, Galea MP, Eldridge BJ, Harris SR. Performance of 2-year-old children after early surgery for congenital heart disease on the Bayley Scales of Infant and Toddler Development, Third Edition. Early Hum Dev. 2012;88:603–7.CrossRefPubMed
10.
go back to reference Walker K, Holland AJA, Winlaw D, Sherwood M, Badawi N. Neurodevelopmental outcomes and surgery in neonates. J Paediatr Child Health. 2006;42:749–51.CrossRefPubMed Walker K, Holland AJA, Winlaw D, Sherwood M, Badawi N. Neurodevelopmental outcomes and surgery in neonates. J Paediatr Child Health. 2006;42:749–51.CrossRefPubMed
11.
go back to reference Walker K, Badawi N, Holland AJ, Halliday R. Developmental outcomes following major surgery: what does the literature say? J Paediatr Child Health. 2011;47:766–70.CrossRefPubMed Walker K, Badawi N, Holland AJ, Halliday R. Developmental outcomes following major surgery: what does the literature say? J Paediatr Child Health. 2011;47:766–70.CrossRefPubMed
12.
go back to reference Walker K, Loughran-Fowlds A, Halliday R, Holland AJA, Stewart J, Sholler GF, et al. Developmental outcomes at three years of age following major non-cardiac and cardiac surgery in term infants: a population-based study Journal of Pediatrics and Child Health. 2015; In press. Walker K, Loughran-Fowlds A, Halliday R, Holland AJA, Stewart J, Sholler GF, et al. Developmental outcomes at three years of age following major non-cardiac and cardiac surgery in term infants: a population-based study Journal of Pediatrics and Child Health. 2015; In press.
13.
go back to reference Walker K, Badawi N, Halliday R, Stewart J, Sholler GF, Winlaw DS, et al. Early developmental outcomes following major noncardiac and cardiac surgery in term infants: a population-based study. J Pediatr. 2012;161:748–52. e1.CrossRefPubMed Walker K, Badawi N, Halliday R, Stewart J, Sholler GF, Winlaw DS, et al. Early developmental outcomes following major noncardiac and cardiac surgery in term infants: a population-based study. J Pediatr. 2012;161:748–52. e1.CrossRefPubMed
14.
go back to reference Bayley N. Bayley’s Scales of Infant and Toddler Development. 3rd ed. San Antonio, Tx: The Psychological Corporation; 2006. Bayley N. Bayley’s Scales of Infant and Toddler Development. 3rd ed. San Antonio, Tx: The Psychological Corporation; 2006.
15.
go back to reference Spittle AJ, Spencer-Smith MM, Eeles AL, Lee KJ, Lorefice LE, Anderson PJ, et al. Does the Bayley-III Motor Scale at 2 years predict motor outcome at 4 years in very preterm children? Dev Med Child Neurol. 2013;55:448–52.CrossRefPubMed Spittle AJ, Spencer-Smith MM, Eeles AL, Lee KJ, Lorefice LE, Anderson PJ, et al. Does the Bayley-III Motor Scale at 2 years predict motor outcome at 4 years in very preterm children? Dev Med Child Neurol. 2013;55:448–52.CrossRefPubMed
16.
go back to reference Walker K, Badawi N, Halliday R, Laing S. Brief Report: Performance of Australian Children at One Year of Age on the Bayley Scales of Infant and Toddler Development (Version III). Australian Educ Dev Psychol. 2010;27:54–8.CrossRef Walker K, Badawi N, Halliday R, Laing S. Brief Report: Performance of Australian Children at One Year of Age on the Bayley Scales of Infant and Toddler Development (Version III). Australian Educ Dev Psychol. 2010;27:54–8.CrossRef
17.
go back to reference Luttikhuizen dos Santos ES L d, de Kieviet JF, Konigs M, van Elburg RM, Oosterlaan J. Predictive value of the Bayley Scales of Infant Development on development of very preterm/very low birth weight children: A meta-analysis. Early Hum Dev. 2013;89:487–96. Luttikhuizen dos Santos ES L d, de Kieviet JF, Konigs M, van Elburg RM, Oosterlaan J. Predictive value of the Bayley Scales of Infant Development on development of very preterm/very low birth weight children: A meta-analysis. Early Hum Dev. 2013;89:487–96.
18.
go back to reference Milne S, McDonald J, Comino EJ. The use of the Bayley Scales of Infant and Toddler Development III with clinical populations: A preliminary exploration. Phys Occup Ther Pediatr. 2012;32:24–33.CrossRefPubMed Milne S, McDonald J, Comino EJ. The use of the Bayley Scales of Infant and Toddler Development III with clinical populations: A preliminary exploration. Phys Occup Ther Pediatr. 2012;32:24–33.CrossRefPubMed
19.
go back to reference Dwyer GM, Hardy LL, Peat JK, Baur LA. The validity and reliability of a home environment preschool-age physical activity questionnaire (Pre-PAQ). Int J Behav Nutr Phys Act. 2011;8:86.CrossRefPubMedPubMedCentral Dwyer GM, Hardy LL, Peat JK, Baur LA. The validity and reliability of a home environment preschool-age physical activity questionnaire (Pre-PAQ). Int J Behav Nutr Phys Act. 2011;8:86.CrossRefPubMedPubMedCentral
20.
go back to reference Peat J, Barton B. Medical Statistics: A Guide to Data Analysis and Critical Appraisal. Chichester, GBR: Wiley; 2008. Peat J, Barton B. Medical Statistics: A Guide to Data Analysis and Critical Appraisal. Chichester, GBR: Wiley; 2008.
21.
go back to reference Kuo YL, Liao HF, Chen PC, Hsieh WS, Hwang HW. The influence of wakeful prone positioning on motor development during the early life. J Dev Behav Pediatr. 2008;29:367–76.CrossRefPubMed Kuo YL, Liao HF, Chen PC, Hsieh WS, Hwang HW. The influence of wakeful prone positioning on motor development during the early life. J Dev Behav Pediatr. 2008;29:367–76.CrossRefPubMed
22.
go back to reference Danzer E, Gerdes M, D’Agostino JA, Partridge EA, Hoffman-Craven CH, Bernbaum J, et al. Preschool neurological assessment in congenital diaphragmatic hernia survivors: outcome and perinatal factors associated with neurodevelopmental impairment. Early Hum Dev. 2013;89:393–400.CrossRefPubMed Danzer E, Gerdes M, D’Agostino JA, Partridge EA, Hoffman-Craven CH, Bernbaum J, et al. Preschool neurological assessment in congenital diaphragmatic hernia survivors: outcome and perinatal factors associated with neurodevelopmental impairment. Early Hum Dev. 2013;89:393–400.CrossRefPubMed
23.
go back to reference Serenius F, Kallen K, Blennow M, Ewald U, Fellman V, Holmstrom G, et al. Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden. Jama. 2013;309:1810–20.CrossRefPubMed Serenius F, Kallen K, Blennow M, Ewald U, Fellman V, Holmstrom G, et al. Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden. Jama. 2013;309:1810–20.CrossRefPubMed
24.
go back to reference Johnson S, Hennessy E, Smith R, Trikic R, Wolke D, Marlow N. Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure study. Arch Dis Child Fetal Neonatal Ed. 2009;94:F283–9.CrossRefPubMed Johnson S, Hennessy E, Smith R, Trikic R, Wolke D, Marlow N. Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure study. Arch Dis Child Fetal Neonatal Ed. 2009;94:F283–9.CrossRefPubMed
25.
go back to reference Pitcher JB, Schneider LA, Burns NR, Drysdale JL, Higgins RD, Ridding MC, et al. Reduced corticomotor excitability and motor skills development in children born preterm. J Physiol Lond. 2012;590:5827–44.CrossRefPubMedPubMedCentral Pitcher JB, Schneider LA, Burns NR, Drysdale JL, Higgins RD, Ridding MC, et al. Reduced corticomotor excitability and motor skills development in children born preterm. J Physiol Lond. 2012;590:5827–44.CrossRefPubMedPubMedCentral
26.
go back to reference Tanis JC, Van Braeckel KN, Kerstjens JM, Bocca-Tjeertes IF, Reijneveld SA, Bos AF. Functional outcomes at age 7 years of moderate preterm and full term children born small for gestational age. J Pediatr. 2015;166:552–8. e1.CrossRefPubMed Tanis JC, Van Braeckel KN, Kerstjens JM, Bocca-Tjeertes IF, Reijneveld SA, Bos AF. Functional outcomes at age 7 years of moderate preterm and full term children born small for gestational age. J Pediatr. 2015;166:552–8. e1.CrossRefPubMed
27.
go back to reference Aylward GP. Update on neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2014;35:392–3.CrossRefPubMed Aylward GP. Update on neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2014;35:392–3.CrossRefPubMed
28.
go back to reference Quigley MA, Poulsen G, Boyle E, Wolke D, Field D, Alfirevic Z, et al. Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study. Arch Dis Child Fetal Neonatal Ed. 2012;97:F167–73.CrossRefPubMed Quigley MA, Poulsen G, Boyle E, Wolke D, Field D, Alfirevic Z, et al. Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study. Arch Dis Child Fetal Neonatal Ed. 2012;97:F167–73.CrossRefPubMed
29.
go back to reference Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int. 2011;8:98. Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int. 2011;8:98.
30.
go back to reference Summerbell CD, Moore HJ, Vogele C, Kreichauf S, Wildgruber A, Manios Y, et al. Evidence-based recommendations for the development of obesity prevention programs targeted at preschool children. Obes Rev. 2012;13 Suppl 1:129–32.CrossRefPubMed Summerbell CD, Moore HJ, Vogele C, Kreichauf S, Wildgruber A, Manios Y, et al. Evidence-based recommendations for the development of obesity prevention programs targeted at preschool children. Obes Rev. 2012;13 Suppl 1:129–32.CrossRefPubMed
31.
go back to reference Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O’Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;21:CD001872. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O’Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;21:CD001872.
32.
go back to reference Saavalainen PM, Luoma L, Laukkanen E, M Bowler D, Maatta S, Kiviniemi V, et al. School performance of adolescents born preterm: neuropsychological and background correlates. Europ J Paediatr Neurol. 2008;12:246–52.CrossRef Saavalainen PM, Luoma L, Laukkanen E, M Bowler D, Maatta S, Kiviniemi V, et al. School performance of adolescents born preterm: neuropsychological and background correlates. Europ J Paediatr Neurol. 2008;12:246–52.CrossRef
33.
go back to reference Dwyer GM, Baur LA, Higgs J, Hardy LL. Promoting children’s health and wellbeing: broadening the therapy perspective. Phys Occup Ther Pediatr. 2009;29:27–43.CrossRefPubMed Dwyer GM, Baur LA, Higgs J, Hardy LL. Promoting children’s health and wellbeing: broadening the therapy perspective. Phys Occup Ther Pediatr. 2009;29:27–43.CrossRefPubMed
34.
go back to reference Danzer E, Hedrick HL. Neurodevelopmental and neurofunctional outcomes in children with congenital diaphragmatic hernia. Early Hum Dev. 2011;87:625–32.CrossRefPubMed Danzer E, Hedrick HL. Neurodevelopmental and neurofunctional outcomes in children with congenital diaphragmatic hernia. Early Hum Dev. 2011;87:625–32.CrossRefPubMed
35.
go back to reference McGowan JE, Alderdice FA, Doran J, Holmes VA, Jenkins J, Craig S, et al. Impact of neonatal intensive care on late preterm infants: developmental outcomes at 3 years. Pediatrics. 2012;130:e1105–12.CrossRefPubMed McGowan JE, Alderdice FA, Doran J, Holmes VA, Jenkins J, Craig S, et al. Impact of neonatal intensive care on late preterm infants: developmental outcomes at 3 years. Pediatrics. 2012;130:e1105–12.CrossRefPubMed
Metadata
Title
Developmental outcomes and physical activity behaviour in children post major surgery: an observational study
Authors
Genevieve Mary Dwyer
Karen Walker
Louise Baur
Nadia Badawi
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0660-4

Other articles of this Issue 1/2016

BMC Pediatrics 1/2016 Go to the issue