Functional outcome at school age of children born with gastroschisis

Chiara C M M Lap; Sandra W Bolhuis; Koenraad N J A Van Braeckel; Sijmen A Reijneveld; Gwendolyn T R Manten; Arend F Bos; Jan B F Hulscher

doi:10.1016/j.earlhumdev.2017.01.005

Functional outcome at school age of children born with gastroschisis

Early Hum Dev. 2017 Mar-Apr:106-107:47-52. doi: 10.1016/j.earlhumdev.2017.01.005. Epub 2017 Feb 9.

Authors

Chiara C M M Lap¹, Sandra W Bolhuis², Koenraad N J A Van Braeckel³, Sijmen A Reijneveld⁴, Gwendolyn T R Manten⁵, Arend F Bos⁶, Jan B F Hulscher⁷

Affiliations

¹ University Medical Center Utrecht, Division Woman and Baby, Department of Obstetrics, Lundlaan 6, Post number KE.04.123.1, Postbox 85090, 3508 AB Utrecht, The Netherlands. Electronic address: c.c.m.m.lap@umcutrecht.nl.
² University Medical Center Groningen, University of Groningen, Department of Paediatric Surgery Beatrix Children's Hospital, BA-21, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. Electronic address: sandra_bolhuis@hotmail.com.
³ University Medical Center Groningen, University of Groningen, Division of Neonatology Beatrix Children's Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: koenraad-vanbraeckel@uiowa.edu.
⁴ University Medical Center Groningen, University of Groningen, Department of Health Sciences, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: s.a.reijneveld@umcg.nl.
⁵ University Medical Center Utrecht, Division Woman and Baby, Department of Obstetrics, Lundlaan 6, Post number KE.04.123.1, Postbox 85090, 3508 AB Utrecht, The Netherlands. Electronic address: g.t.r.manten@umcutrecht.nl.
⁶ University Medical Center Groningen, University of Groningen, Division of Neonatology Beatrix Children's Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: a.f.bos@umcg.nl.
⁷ University Medical Center Groningen, University of Groningen, Department of Paediatric Surgery Beatrix Children's Hospital, BA-21, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. Electronic address: j.b.f.hulscher@umcg.nl.

PMID: 28189001
DOI: 10.1016/j.earlhumdev.2017.01.005

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.

Keywords: Behavioural outcome; Cognitive; Functional outcome; Gastroschisis; Long-term follow-up; Motor; Physical; School age.

MeSH terms

Adolescent
Adolescent Development*
Attention
Case-Control Studies
Child
Child Development*
Executive Function
Female
Gastroschisis / epidemiology*
Humans
Infant, Newborn
Intelligence
Male
Neurodevelopmental Disorders / epidemiology*
Psychomotor Performance