Abstract
Introduction: Gastroschisis is a congenital malformation that has risk factors for delayed neuropsychomotor development. That is why it is important to recognize early developmental changes in these newborns during hospitalization in the Neonatal Intensive Care Unit. Objective: To evaluate the motor performance of newborns with gastroschisis after surgical correction. Methods: An observational and retrospective study was carried out with newborns with gastroschisis, assessed by the Test of Infant Motor Performance at the Neonatal Intensive Care Center 2 of the Instituto da Criança e do Adolescente. The test allows the classification of the risk for developmental delay in 4 categories: within the average for age, low average, below average, and well below average. Maternal, neonatal, surgical, and motor assessment data were collected through electronic medical records. Results: Motor assessment was performed on 17 newborns, where 88.23% were classified as “below average” for age. The mean maternal age was 20 years, and the average gestational age and birth weight were 36.38 weeks and 2343.9 grams, respectively, with the majority being female. Simple gastroschisis accounted for 64.71%, and primary closure was possible in 82.35%. The average hospital stay of 53.24 days, and sepsis was the most frequent complication (64.71%). Conclusion: Newborns with gastroschisis remain hospitalized for a long time and are susceptible to complications. It was possible to identify the delay in the development of these newborns early during hospitalization, which allows intervention by physiotherapy before the delay worsens.
Highlights
Gastroschisis is a congenital malformation that has risk factors for delayed neuropsychomotor development
Developmental changes were found in more than 80% of the sample, classified as “below average” for age according to the normative test table. What do these findings mean? This study shows that newborns with gastroschisis have developmental changes in the neonatal period, and multidisciplinary monitoring is important
The advancement of care in the neonatal intensive care unit (NICU) and surgical techniques increased the survival of newborns (NBs) with various malformations and raised concerns about morbidities resulting from hospitalization, such as changes in neuropsychomotor development (DNPM)
Summary
Gastroschisis is a congenital malformation that has risk factors for delayed neuropsychomotor development. DNPM alteration is multifactorial, and conditions such as low birth weight, congenital malformations, need for surgical procedures, prolonged hospitalization, mechanical ventilation, use of supplemental oxygen[1], pain, sedation, analgesia[3], sepsis, and maternal characteristics[4,5] can influence neurological development. In this context, gastroschisis is one of the most common malformations of the abdominal wall that requires intensive care and has risk factors for changes in the DNPM1,6. Its prevalence is approximately 2.98 per 10,000 live births and can be classified as simple when only the exteriorization of Organs abdominal organs occurs without the association of other changes and complex when there is the presence of intestinal atresia, perforation, necrotic segments, or intestinal volvulus[7]
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