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Long-term neurodevelopment in children born with esophageal atresia: a systematic review
Camille E van Hoorn1,2, Chantal A Ten Kate2, Andre B Rietman3
1Department of Anaesthesiology, Erasmus MC-Sophia Children's Hospital University Medical Centre, Rotterdam, The Netherlands.
Insights
Children with esophageal atresia (EA) face uncertain long-term neurodevelopmental risks. This review highlights frequent motor and cognitive impairments, underscoring the need for proactive follow-up programs.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Surgical Outcomes
Background:
- Esophageal atresia (EA) survival rates exceed 90%, but long-term neurodevelopmental outcomes remain unclear.
- Existing studies on long-term neurodevelopmental deficits in EA survivors yield conflicting results.
- This review synthesizes current knowledge on the neurodevelopmental trajectory of children with EA.
Purpose of the Study:
- To provide a comprehensive overview of the current knowledge regarding the long-term neurodevelopmental outcome of children with esophageal atresia.
- To identify patterns and consistencies in reported neurodevelopmental deficits in EA survivors across different age groups.
Main Methods:
- A structured literature search was conducted across major databases including Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar.
- Keywords used in the search were 'esophageal atresia', 'long-term outcome', 'motor development', 'cognitive development', and 'neurodevelopment'.
- The search was performed on November 8, 2020, and 15 relevant studies were included in the final analysis.
Main Results:
- Of the 15 included studies, five reported outcomes at multiple time points or ages.
- Impaired neurodevelopment was noted in infants (1 study), preschoolers (2 studies), and school-aged children (1 study).
- Motor function impairments were consistently reported across age groups, with cognitive impairments also identified in several studies.
Conclusions:
- Long-term neurodevelopmental outcomes in children with EA are variable, with significant concerns regarding both motor and cognitive functions.
- The findings suggest a need for structured, multidisciplinary follow-up programs for early detection and intervention of neurodevelopmental impairments in EA survivors.
- Proactive monitoring and intervention are crucial for optimizing the long-term well-being of children born with esophageal atresia.
Background:
Although the survival rate of esophageal atresia (EA) has increased to over 90%, the risk of functional long-term neurodevelopmental deficits is uncertain. Studies on long-term outcomes of children with EA show conflicting results. Therefore, we provide an overview of the current knowledge on the long-term neurodevelopmental outcome of children with EA.
Methods:
We performed a structured literature search in Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google scholar on November 8, 2020 with the keywords 'esophageal atresia', 'long-term outcome', 'motor development', 'cognitive development', and 'neurodevelopment'.
Results:
The initial search identified 945 studies, of which 15 were included. Five of these published outcomes of multiple tests or tested at multiple ages. Regarding infants, one of six studies found impaired neurodevelopment at 1 year of age. Regarding preschoolers, two of five studies found impaired neurodevelopment; the one study assessing cognitive development found normal cognitive outcome. Both studies on motor function reported impairment. Regarding school-agers, the one study on neurodevelopmental outcome reported impairment. Cognitive impairment was found in two out of four studies, and motor function was impaired in both studies studying motor function.
Conclusions:
Long-term neurodevelopment of children born with EA has been assessed with various instruments, with contrasting results. Impairments were mostly found in motor function, but also in cognitive performance. Generally, the long-term outcome of these children is reason for concern. Structured, multidisciplinary long-term follow-up programs for children born with EA would allow to timely detect neurodevelopmental impairments and to intervene, if necessary.
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