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Quality of Life Outcomes in Children Following Surgical Management of Gastroschisis: A Systematic Review and
Meagan E Wiebe1, Cesar Kattini2, Victoria Larocca2
1Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Insights
Quality of life for children with gastroschisis shows better physical functioning but poorer abdominal pain and constipation. These symptoms require attention during parental counseling for improved pediatric care.
Area of Science:
- Pediatric Surgery
- Quality of Life Research
- Gastrointestinal Health
Background:
- Quality of life (QoL) in pediatric gastroschisis patients is under-documented.
- Systematic review needed to synthesize existing QoL data.
Purpose of the Study:
- To quantitatively summarize parent and child-reported QoL outcomes in children with gastroschisis.
- Identify specific QoL domains and gastrointestinal symptoms impacting this population.
Main Methods:
- Systematic review and random effects meta-analysis.
- Searched MEDLINE, PsycInfo, EBM Reviews, and Embase databases.
- Included studies reporting QoL, GI symptoms, and nutritional limitations.
Main Results:
- Pooled parent-reported QoL: higher physical/emotional, lower psychosocial/school functioning.
- Pooled child-reported QoL: higher physical/social, lower emotional/school functioning.
- Parent-reported GI symptoms: improved heartburn, reflux, swallowing, nausea, vomiting, diarrhea; worse abdominal pain, constipation.
Conclusions:
- Pediatric gastroschisis patients exhibit better physical functioning but poorer outcomes regarding abdominal pain and constipation.
- These specific symptoms (abdominal pain, constipation) are critical for parental counseling.
Background:
The quality of life of pediatric patients born with gastroschisis has yet to be documented in a systematic review. Our objective is to quantitatively summarize the parent and child-reported quality of life outcomes of children born with gastroschisis.
Methods:
Records were sourced from the MEDLINE, PsycInfo, EBM Reviews, and Embase databases. Studies that examined child and parent-reported quality of life outcomes in pediatric patients with gastroschisis were included. Screening and data extraction was conducted by three reviewers. The primary outcome was the reported quality of life functioning scores, and the secondary outcomes included gastrointestinal symptoms and nutritional limitations. A random effects meta-analysis and sensitivity analysis were performed.
Results:
2695 articles were screened, and eight studies were included. Pooled parent-reported quality of life mean estimate scores were higher in the realms of physical and emotional functioning, with lower psychosocial and school functioning scores. Child-reported pooled standardized mean scores showed higher perceived physical functioning and social functioning with lower emotional and school functioning scores. Pooled parent-reported gastrointestinal symptom mean estimate scores showed higher heartburn and reflux, difficulty swallowing, nausea and vomiting, diarrhea, and food and drink limitation scores, representing improved clinical outcomes in those domains. Lower scores were noted in the domains of abdominal pain and constipation, indicating worse clinical outcomes in these domains.
Conclusion:
The pediatric gastroschisis population has better quality of life scores in physical functioning with poorer abdominal pain and constipation scores. These symptoms should be highlighted when counselling the parents of these patients.
Level Of Evidence:
V.
Type Of Study:
Reviews, Systematic Reviews, Meta-Analyses, and Guidelines.
