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School age educational outcomes of infants born with congenital diaphragmatic hernia
Alyssa R Walden1, Wendy N Nembhard1,2,3, Chary Akmyradov4
1Department of Pediatrics (Neonatal-Perinatal Medicine), Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Insights
Children with congenital diaphragmatic hernia (CDH) show similar academic performance to controls. However, factors like oxygen at discharge and longer hospital stays predict lower academic achievement in CDH patients.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Academic Performance Research
Background:
- Congenital diaphragmatic hernia (CDH) is a complex birth defect.
- Long-term neurodevelopmental outcomes, including academic proficiency, require further investigation.
Purpose of the Study:
- To compare academic proficiency in children with CDH versus healthy controls.
- To identify predictors of academic performance in children diagnosed with CDH.
Main Methods:
- Retrospective cohort study using Arkansas birth and education databases (2000-2005).
- Matched controls for hospital, birth month, sex, and race/ethnicity.
- Academic proficiency assessed via 4th-grade literacy and math tests; multivariable logistic regression used.
Main Results:
- No significant differences in literacy or math proficiency between CDH cases (n=25) and controls (n=31).
- Among CDH cases, oxygen at discharge was linked to lower literacy.
- Medicaid payer and longer hospital stay were associated with poorer math proficiency.
Conclusions:
- Children with CDH demonstrate comparable academic proficiency to their peers.
- Post-discharge oxygen, Medicaid insurance, and extended hospital stays are potential indicators of lower academic performance in CDH survivors.
Background:
To compare academic proficiency among children with congenital diaphragmatic hernia (CDH) versus controls and identify predictors of academic performance among children with CDH.
Methods:
Infants born with CDH in Arkansas, 2000-2005, were identified from the Arkansas Reproductive Health Monitoring System. For each case, two controls were selected from birth certificate data and matched for hospital and month of birth, sex, and race/ethnicity. Data on re-hospitalization within the first 5 years and payer data were collected from the Arkansas Hospital Inpatient Discharge database. Surviving cases and controls were linked to the Arkansas Department of Education database. Primary outcomes were odds of proficiency on fourth grade literacy and mathematics achievement tests. Multivariable logistic regression models evaluated the association between study characteristics and academic proficiency.
Results:
The final study cohort included 25 surviving CDH cases and 31 controls who were linked to their education data. After adjusting for differences in characteristics (5-min Apgar score and associated congenital anomalies) between cases and controls, there were no statistically significant differences in literacy (72% vs. 84%, p = .93) or mathematics (64% vs. 81%, p = .98) test proficiency between the two groups. In multivariable analyses, among CDH cases, oxygen at discharge and Medicaid payer/longer hospital stay were associated with worse fourth grade literacy and mathematics proficiency, respectively.
Conclusions:
Oxygen at discharge, Medicaid payer, and longer hospital stay were associated with lower academic performance among CDH cases.
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