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

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.