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Long-term motor and cognitive outcome in children with congenital diaphragmatic hernia
Isabell Tureczek1, Jon Caflisch, Ulrich Moehrlen
1Child Development Center, University Children's Hospital, Zurich, Switzerland.
Insights
Children with congenital diaphragmatic hernia (CDH) often have normal cognitive development but may experience motor deficits. Genetic comorbidity is linked to poorer outcomes, highlighting the need for ongoing neurodevelopmental monitoring and early intervention for CDH survivors.
Area of Science:
- Pediatric Surgery
- Developmental Pediatrics
- Clinical Genetics
Background:
- Congenital diaphragmatic hernia (CDH) is a serious birth defect requiring surgical correction.
- Long-term neurodevelopmental outcomes in CDH survivors are not fully understood.
- Genetic comorbidities can influence outcomes in pediatric conditions.
Purpose of the Study:
- To assess the cognitive and motor development of children surviving surgically corrected CDH.
- To identify factors associated with neurodevelopmental outcomes in this cohort.
Main Methods:
- A cohort of 33 CDH survivors (mean age 8.6 years) underwent neurodevelopmental assessment.
- Cognitive function was evaluated using Wechsler scales.
- Motor skills were assessed with the Movement Assessment Battery for Children and Zurich Neuromotor Assessment.
Main Results:
- Children without genetic comorbidity showed normal cognitive outcomes (median IQ 103).
- Fine and gross motor skills were significantly poorer than age-matched norms (p=0.008 and p=0.001, respectively).
- Genetic comorbidity was the strongest predictor of lower IQ and impaired motor performance.
Conclusions:
- Surgically corrected CDH is associated with favorable cognitive outcomes in the absence of genetic comorbidity.
- Motor deficits are common in CDH survivors and require attention.
- Genetic factors significantly impact neurodevelopmental outcomes, necessitating tailored parental counseling and long-term follow-up for early intervention.
Aims:
To determine the motor and cognitive outcome in a regional cohort of survivors of surgically corrected congenital diaphragmatic hernia.
Methods:
Thirty-three children (85% of survivors) were examined at a mean age of 8.6 years (3.3-15.7 years), seven had a genetic comorbidity. Outcome was assessed with the Wechsler Preschool and Primary Scale of Intelligence 3rd version and the Wechsler Intelligence Scale 4th version. Motor performance was tested with the Movement Assessment Battery for Children 2nd edition in children younger than 5 years and thereafter with the Zurich Neuromotor Assessment.
Results:
Children without a genetic comorbidity had a normal cognitive outcome (median IQ 103, 70-121), but fine motor (p = 0.008) and gross motor outcome (p = 0.001) were poorer than the norm. Medical variables were not predictive of adverse outcome, whereas genetic comorbidity was the strongest predictor of low IQ (p < 0.001) and of poor motor performance (p = 0.04).
Conclusions:
In the absence of a genetic comorbidity, children with congenital diaphragmatic hernia have a favourable cognitive outcome, but motor outcome may be affected. This needs to be taken into account for parental counselling. Further, long-term neurodevelopmental assessment in children with congenital diaphragmatic hernia is important to provide early therapeutic interventions.
