Functional outcome at school age of children born with gastroschisis. (March 2017)

• Record Type: Journal Article
• Authors: Lap, Chiara C.M.M.; Bolhuis, Sandra W.; Van Braeckel, Koenraad N.J.A.; Reijneveld, Sijmen A.; Manten, Gwendolyn T.R.; Bos, Arend F.; Hulscher, Jan B.F.
• Is Part Of: Early human development. Volume 106/107(2017)
• Page Start: 47
• Page End: 52
• Publication Date: 2017-03
• Subjects: AGA Average for gestational age -- AVLT Rey Auditory Verbal Learning Test -- BRIEF Behaviour Rating Inventory of Executive Function, Dutch version -- BSID-III Bayley Scales of Infant and Toddler Development 3rd Edition -- CBCL Child Behavior Checklist -- CI confidence interval -- GA gestational age -- IQ intelligence quotient -- Lollipop Longitudinal Preterm Outcome Project -- M-ABC Movement Assessment Battery for Children -- Nepsy-2-NL Developmental Neuropsychological Assessment Battery, Second Edition Dutch version -- NICU Neonatal Intensive Care Unit -- OR odds ratio -- PIQ performance IQ -- RR relative risk -- SES socioeconomic status -- SGA small for gestational age -- TEA-Ch NL Test of Everyday Attention for Children, Dutch version -- TPN total parenteral nutrition -- TIQ total IQ -- UMCG University Medical Center Groningen -- WISC-III-NL Wechsler Intelligence Scale, Third Edition, Dutch Version -- VIQ verbal IQ; Gastroschisis -- Functional outcome -- Physical -- Motor -- Cognitive -- Behavioural outcome -- School age -- Long-term follow-up; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2017.01.005
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Objective: We aimed to determine motor, cognitive and behavioural outcomes of school aged children born with gastroschisis compared to matched controls. Study design: We compared outcomes of 16 children born with gastroschisis treated at the University Medical Center Groningen, the Netherlands, between 1999 and 2006 with 32 controls matched for gender, gestational age, birth weight, and corrected for small for gestational age (SGA) and parental socioeconomic status (SES). Intelligence, auditory-verbal memory, attention, response inhibition, visual perception, motor skills, visuomotor integration, problem behaviour and executive functioning were evaluated. Results: Median verbal intelligence quotient and global executive functioning scores of children born with gastroschisis were poorer than of controls (95 (inter quartile range (IQR) 88–100) vs. 104 (IQR 98–113), P = 0.001, and 29 (IQR 6.8–63.8) vs. 5.0 (IQR 2.8–19.8), P = 0.03, respectively). Children with gastroschisis were more often classified as borderline or abnormal than controls regarding response inhibition (odds ratio (OR) 20.4; 95%-confidence interval (95%-CI); 2.4–171.5), selective visual attention (OR 40.4; 95%-CI 5.9–275.4), sustained auditory attention (OR 88.1; 95%-CI 5.8–1342.8), and fine motor skills (50% vs. 0%). Grade retention was more prevalent in gastroschisis children (OR 6.07; 95%-CI 1.42–25.9). These associations persisted after adjustment for SGA and SES. The auditory-verbal memory, visuomotor integration and behavioural problems did not significantly differ from the controls. Conclusions: Gastroschisis is associated with poorer verbal intelligence, and with an increased risk for poor performance on several aspects of attention, response inhibition and fine motor skills at school age. The follow-up of children born with gastroschisis deserves attention regarding these specific domains, to improve their functional outcomes. Highlights: Children born with gastroschisis have excellent neonatal survival rates (> 90%). The disorder and the required treatment in early life may harm neurodevelopment of these children, but evidence lacks. Functional outcome at school age of gastroschisis children is poorer than expected from studies at pre-school age. Intelligence, attention, executive functioning and fine motor skill performances are particularly affected. Close follow up of the development of children born with gastroschisis during (pre-school) age is recommended.