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The long-term neurodevelopmental and psychological outcomes of gastroschisis: A cohort study
Emma L Harris1, Susannah J Hart2, Corrado Minutillo3
1Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women, Perth, WA, Australia; Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, WA, Australia; Biostatistics Unit, Women and Infants Research Foundation, Perth, WA, Australia.
Insights
Children born with gastroschisis show normal intellectual abilities but may experience challenges in working memory and behavior. Parenting relationships may also be affected, suggesting long-term impacts beyond early childhood.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Congenital Anomalies Research
Background:
- Gastroschisis is a congenital defect with known impacts on early development.
- Previous studies on gastroschisis survivors have primarily focused on neurodevelopmental outcomes within the first three years of life.
Purpose of the Study:
- To evaluate the intellectual, behavioral, and neurological outcomes in older children and adolescents who survived gastroschisis.
- To extend the understanding of long-term neurodevelopmental trajectories in gastroschisis survivors beyond early childhood.
Main Methods:
- A cohort of 42 gastroschisis survivors (aged 5-17 years) was assessed.
- Evaluations included intellectual ability (Wechsler scales), neurological status, hearing, vision, behavior (Strengths and Difficulties Questionnaire), and parenting style (Parenting Relationship Questionnaire).
- Results were compared against normative data.
Main Results:
- No significant cerebral palsy or hearing loss was observed; one case of amblyopia.
- Mean full-scale IQ was within the normal range (98.2), but working memory index showed a significant decrease (p=0.038).
- Behavioral scores were significantly lower in several domains, and parenting relationship scores indicated abnormalities in multiple areas.
Conclusions:
- While overall intellectual abilities remain within normal limits, gastroschisis survivors may experience deficits in working memory.
- Behavioral difficulties and altered parenting relationship dynamics are notable findings in older children and adolescents.
- These long-term outcomes may be linked to perinatal factors, gastroschisis management, complications, or socioeconomic influences.
Objectives:
Previous gastroschisis specific neurodevelopmental studies have focused on the first 3years of life. The aim of this study was to assess the intellectual, behavioral and neurological outcomes of older children and adolescents born with gastroschisis.
Study Design:
Of 99 gastroschisis survivors born in Western Australia, 1992 to 2005, and who were at least 5years old, 42 agreed to take part in this study. The study assessed: intellectual ability, with age appropriate Wechsler intelligence scales; neurological status; hearing; vision; behavioral status with the Strengths and Difficulties Questionnaire (SDQ); and parenting style with the Parenting Relationship Questionnaire (PRQ). All results were compared to normative means.
Results:
Median age at follow-up was 10years (range 5-17). No child had evidence of cerebral palsy or hearing loss; 1 child had amblyopia. Psychometric tests were completed in 39 children: mean full scale IQ was 98.2 (standard deviation [SD] 10.7); the working memory index was the only subscale to show a significant decrease from the normative mean (mean 95.5, SD 12.4, p=0.038). The mean SDQ behavioral scores were significantly lower for 3 of 5 domains and the Total Difficulties score. PRQ scores were significantly abnormal for 4 of 7 domains: Communication, Discipline, Satisfaction with School and Relational Frustration.
Conclusions:
Overall intellectual abilities were within a normal range. The decrease in working memory index and the behavioral and parenting relationship impairments could be an effect of perinatal factors, gastroschisis management and complications or the complexity of the socio-economic environment.
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