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Long-term neurodevelopmental outcomes in children born with gastroschisis: the tiebreaker
Adam S Gorra1, Howard Needelman, Kenneth S Azarow
1Division of Pediatric Surgery, Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Insights
Children with gastroschisis show similar 2-year neurodevelopmental outcomes compared to similar infants without surgery. Both groups, however, enroll in early intervention services more frequently than healthy peers, suggesting prematurity impacts development.
Area of Science:
- Neonatal surgery
- Pediatric neurodevelopment
- Developmental pediatrics
Background:
- Gastroschisis is a congenital abdominal wall defect requiring surgical repair.
- Neurodevelopmental outcomes in infants with gastroschisis are a significant clinical concern.
- Early identification of developmental delays is crucial for timely intervention.
Purpose of the Study:
- To evaluate 2-year neurodevelopmental outcomes in children born with gastroschisis.
- To compare neurodevelopmental trajectories of gastroschisis survivors with a matched control group.
- To identify factors influencing neurodevelopmental outcomes in this population.
Main Methods:
- Retrospective review of medical records for children with gastroschisis treated between 2001 and 2008.
- Utilized the Developmental Tracking Infant Progress Statewide (TIPS) program for neurodevelopmental assessments before age 2.
- Compared gastroschisis patients with case-matched, nonsurgical, nonsyndromic neonates of similar gestational age and birth weight.
Main Results:
- Forty-six of 105 children with gastroschisis were followed up with TIPS assessments.
- No statistically significant differences were observed in screening assessment performance between gastroschisis and control groups.
- Enrollment rates in early intervention services did not differ significantly between the two groups.
Conclusions:
- Children with gastroschisis exhibit comparable 2-year neurodevelopmental outcomes to matched controls.
- Both gastroschisis survivors and controls show higher rates of early intervention enrollment than healthy peers.
- Neurodevelopmental delays in gastroschisis are likely associated with prematurity rather than the surgical condition itself.
Purpose:
We evaluated 2-year neurodevelopmental outcomes in children with gastroschisis.
Methods:
We reviewed the records of children with gastroschisis treated between August 2001 and July 2008. Children discharged from the neonatal intensive care unit were referred to the state-sponsored Developmental Tracking Infant Progress Statewide (TIPS) program. We reviewed TIPS assessments performed before age 2 years. School districts evaluated children referred by TIPS and determined their eligibility for early intervention services. Poor outcomes were defined as scores of "failure" or "moderate/high risk" on the screening assessment or enrollment in early intervention services by 2 years. Children with gastroschisis were compared with case-matched nonsurgical, nonsyndromic children of similar gestational age and birth weight.
Results:
One hundred five children were born with gastroschisis, and 46 were followed up with TIPS. There was no statistically significant difference in performance on screening assessments or in the rate of enrollment in early intervention services between the gastroschisis children and controls.
Conclusions:
Children born with gastroschisis have similar 2-year neurodevelopmental outcomes as nonsurgical, nonsyndromic neonatal intensive care unit children of similar gestational age and birth weight. Both groups of children have a higher rate of enrollment in early intervention than their healthy peers. These data suggest that neurodevelopmental outcomes in gastroschisis children are delayed secondary to prematurity rather than the presence of the surgical disease.
