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World J Clin Pediatr. Aug 8, 2014; 3(3): 30-36
Published online Aug 8, 2014. doi: 10.5409/wjcp.v3.i3.30
Neurodevelopmental outcome in congenital diaphragmatic hernia: Evaluation, predictors and outcome
Enrico Danzer, Stephen S Kim
Enrico Danzer, Stephen S Kim, Division of Pediatric Surgery, Department of Surgery, Inova Fairfax Hospital for Children, Virginia Commonwealth University School of Medicine, Fairfax, VA 22003, United States
Author contributions: Danzer E contributed to the study design, literature review, manuscript writing, critical review of final manuscript; Kim SS contributed to the manuscript writing, critical review of final manuscript.
Correspondence to: Stephen S Kim, MD, FACS, FAAP, Clinical Associate Professor of Surgery, Division of Pediatric Surgery, Department of Surgery, Inova Fairfax Hospital for Children, Virginia Commonwealth University School of Medicine, PC, 3301 Woodburn Road, #205 Annandale, Fairfax, VA 22003, United States. skim@pskids.com
Telephone: +1-703-5602236 Fax: +1-703-8764960
Received: March 10, 2014
Revised: May 16, 2014
Accepted: July 25, 2014
Published online: August 8, 2014
Processing time: 177 Days and 14.9 Hours
Abstract

To review the reported neurodevelopmental outcome of congenital diaphragmatic hernia (CDH) survivors, identify important predictors of developmental disabilities, and describe the pathophysiological mechanisms contributing to adverse outcome. A Medline search was performed for English-language articles cross-referencing CDH with pertinent search terms. Retrospective, prospective, and longitudinal follow-up studies were examined. The reference lists of identified articles were also searched. Neurodevelopmental dysfunction has been recognized as one of most common and potentially most disabling outcome of CDH. Intelligence appears to be in the low normal to mildly delayed range. Neuromotor dysfunction is common during early childhood. Behavioral problems, hearing impairment, and quality of life related issues are frequently encountered in older children and adolescence. Disease severity correlates with the degree of neurological dysfunction. Neurodevelopmental follow-up in CDH children should become standard of care to identify those who would benefit from early intervention services and improve neurological outcomes.

Keywords: Congenital diaphragmatic hernia, Extracorporeal membrane oxygenation, Neurodevelopment, Bayley scale of infant development, Wechsler Preschool and Primary Scale of Intelligenc, Developmental disabilities, Quality of life, Autism

Core tip: Neurodevelopmental dysfunction has been recognized as one of the most common comorbidity in congenital diaphragmatic hernia (CDH) and survivors. Disease severity impacts on neurological dysfunction. Neurodevelopmental follow-up in CDH children should become standard of care to improve neurological outcomes.