Neurodevelopmental Outcomes of Very Preterm Infants Who Underwent Neonatal Gastrointestinal Surgery: A Single-Center Retrospective Cohort Study
- 1Division of Neonatology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea .
- 2Division of Pediatric Surgery, Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea .
Abstract
Purpose: Advances in neonatal care have improved the survival of very preterm infants, but neurodevelopment remains a concern. This study aimed to investigate whether neonatal gastrointestinal (GI) surgery independently contributes to adverse neurodevelopmental outcomes in such infants, distinct from the underlying illness severity.
Materials and Methods: In this retrospective cohort study (2011–2023) of infants born at <32 weeks’ gestation, propensity score matching (1:2) yielded 32 surgical and 66 non-surgical infants. Neurodevelopment was assessed using Bayley Scales of Infant and Toddler Development (BSID) II or III at 6–12 and 18–24 months’ corrected age. Brain magnetic resonance images (MRIs) at term-equivalent age (TEA) were analyzed for gross structural abnormalities and white matter injury (WMI).
Results: The surgery group demonstrated a higher rate of gross structural abnormality (31.3% vs. 9.1%, p=0.005) and a numerically higher proportion of moderate WMI (18.7% vs. 6.1%, p=0.079) on TEA-MRI. Neurodevelopmental assessments revealed that the surgery group had lower BSID scores and a higher prevalence of severe impairment (scores <70) in both cognitive and motor domains at all follow-up points (all p<0.05). Multivariable logistic regression identified neonatal GI surgery as being independently associated with severe cognitive delay [adjusted odds ratio (aOR): 11.16, 95% confidence interval (CI): 1.81–68.68] and severe motor delay (aOR: 10.72, 95% CI: 2.13–53.99) at 18–24 months.
Conclusion: Very preterm infants requiring neonatal GI surgery represent a high-risk population for adverse neurodevelopmental outcomes, even after accounting for prematurity and major comorbidities. Long-term neurodevelopmental surveillance and early intervention are warranted in this vulnerable group.
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BibTeX
@article{kim2026neurodevelopmental,
title = {{Neurodevelopmental Outcomes of Very Preterm Infants Who Underwent Neonatal Gastrointestinal Surgery: A Single-Center Retrospective Cohort Study}},
author = {Joo Hi Kim and Sungbo Shim and Ching-yu Lin and Yoonmi Jeong and Sumin Lee and Seung Hwan Baek and Jungho Han and Hoseon Eun and Min Soo Park and In Geol Ho and Jeong Eun Shin},
journal = {Yonsei Medical Journal},
year = {2026},
month = sep,
doi = {10.3349/ymj.2026.0399},
url = {https://doi.org/10.3349/ymj.2026.0399},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Neurodevelopmental Outcomes of Very Preterm Infants Who Underwent Neonatal Gastrointestinal Surgery: A Single-Center Retrospective Cohort Study
AU - Joo Hi Kim
AU - Sungbo Shim
AU - Ching-yu Lin
AU - Yoonmi Jeong
AU - Sumin Lee
AU - Seung Hwan Baek
AU - Jungho Han
AU - Hoseon Eun
AU - Min Soo Park
AU - In Geol Ho
AU - Jeong Eun Shin
PY - 2026
DA - 2026/09/08
JO - Yonsei Medical Journal
DO - 10.3349/ymj.2026.0399
UR - https://doi.org/10.3349/ymj.2026.0399
AB - Purpose: Advances in neonatal care have improved the survival of very preterm infants, but neurodevelopment remains a concern. This study aimed to investigate whether neonatal gastrointestinal (GI) surgery independently contributes to adverse neurodevelopmental outcomes in such infants, distinct from the underlying illness severity. Materials and Methods: In this retrospective cohort study (2011–2023) of infants born at <32 weeks’ gestation, propensity score matching (1:2) yielded 32 surgical and 66 non-surgical infants. Neurodevelopment was assessed using Bayley Scales of Infant and Toddler Development (BSID) II or III at 6–12 and 18–24 months’ corrected age. Brain magnetic resonance images (MRIs) at term-equivalent age (TEA) were analyzed for gross structural abnormalities and white matter injury (WMI). Results: The surgery group demonstrated a higher rate of gross structural abnormality (31.3% vs. 9.1%, p=0.005) and a numerically higher proportion of moderate WMI (18.7% vs. 6.1%, p=0.079) on TEA-MRI. Neurodevelopmental assessments revealed that the surgery group had lower BSID scores and a higher prevalence of severe impairment (scores <70) in both cognitive and motor domains at all follow-up points (all p<0.05). Multivariable logistic regression identified neonatal GI surgery as being independently associated with severe cognitive delay [adjusted odds ratio (aOR): 11.16, 95% confidence interval (CI): 1.81–68.68] and severe motor delay (aOR: 10.72, 95% CI: 2.13–53.99) at 18–24 months. Conclusion: Very preterm infants requiring neonatal GI surgery represent a high-risk population for adverse neurodevelopmental outcomes, even after accounting for prematurity and major comorbidities. Long-term neurodevelopmental surveillance and early intervention are warranted in this vulnerable group.
SN - 0513-5796
SN - 1976-2437
ER -