Neurodevelopmental issues

Imaging in infants born with long-gap OA show globally delayed or diminished brain growth in infants (in particular the corpus callosum) and reduced brain stem growth. (200,201) Motor studies at aged 8 are weaker than peers in 34% of cases, particularly in those with a longer time under anaesthetic. This particularly affects gross motor skills such as balance and ball skills, with normal manual dexterity. (202) 

The authors of research in these areas hypothesise this is the impact of long-term hospitalisation in infancy, and frequent surgery and prolonged general anaesthetic. Research in adolescents born with OA/TOF found motor skills deteriorated in adolescence – this was most common in teens who had had more than one thoracotomy, and it has been speculated that the musculoskeletal deformity thoracotomy can cause may trigger less trunk stability and poorer balance. Associated cardiac anomalies in those with OA/TOF are also strongly associated with poor motor skills in adolescence. (203)