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Developmental problems in patients with oesophageal atresia: a longitudinal follow-up study
  1. Wouter J Harmsen1,
  2. Femke J Aarsen1,
  3. Monique H M van der Cammen-van Zijp1,
  4. Joost M van Rosmalen2,
  5. Rene M H Wijnen1,
  6. Dick Tibboel1,
  7. Hanneke IJsselstijn1
  1. 1Intensive Care and Department of Pediatric Surgery, Erasmus MC—Sophia Children's Hospital, Rotterdam, The Netherlands
  2. 2Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
  1. Correspondence to Dr Hanneke IJsselstijn, Intensive Care and Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Rotterdam 3015 GJ, The Netherlands; h.ijsselstijn{at}erasmusmc.nl

Abstract

Objective To longitudinally evaluate motor development and predictive factors in school-age children with oesophageal atresia.

Design Cohort study with prospective longitudinal follow-up.

Setting Outpatient clinic of a tertiary university paediatric hospital.

Patients Children with oesophageal atresia born between January 1999 and May 2006 were assessed at 5 and 8 years of age.

Interventions None.

Main outcome Motor performance was evaluated at 5 and 8 years using the Movement Assessment Battery for Children (M-ABC). Additionally, we evaluated perinatal characteristics, duration of anaesthesia within the first 24 months, socioeconomic status, sports participation and school performance at time of follow-up and intelligence and sustained attention at the age of 8 years.

Results In 5-year-olds (n=54), the mean (SD) z-score M-ABC was slightly, but significantly lower than age-predicted normative values (−0.75 (0.83), p<0.001). In 8-year-olds (n=49), the z-score M-ABC was −0.53 (0.91) (p<0.001), intelligence was normal, but sustained attention was impaired: z-score speed (−1.50 (1.73)) and raw score attentional fluctuation (3.99 (1.90)) (both p<0.001). Motor problems mainly concerned gross motor performance. Duration of anaesthesia and sustained attention were negatively associated with motor development; sports participation was positively associated.

Conclusions Longer duration of anaesthesia and sustained attention problems were associated with gross motor problems in school-age patients with oesophageal atresia. Parental awareness of risks for motor problems may provide the opportunity to offer timely intervention.

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