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Neurodevelopment of children born with gastroschisis: a scoping review
Bianca de Moraes Rego Martins1, Nathalia Cristina Oliveira de Souza2, Maria Dalva Barbosa Baker Méio3
1Department of Surgery, Surgical NICU, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil. martinsbianca@hotmail.com.
Insights
Neurodevelopment in children with gastroschisis shows mixed results, with some studies reporting normal development and others indicating delays. Complex gastroschisis may pose additional risks for neurodevelopmental impairments.
Area of Science:
- Pediatric Surgery
- Developmental Pediatrics
- Neonatology
Background:
- Gastroschisis, a congenital abdominal wall defect, presents potential risks to infant neurodevelopment.
- Both intrinsic factors (amniotic fluid exposure) and extrinsic factors (hospitalization, pain) may influence neurodevelopment.
- Increased survival rates necessitate understanding long-term neurodevelopmental outcomes.
Purpose of the Study:
- To conduct a scoping review of existing literature on the neurodevelopment of children born with gastroschisis.
- To analyze neurodevelopmental outcomes in motor, cognitive, and language domains.
- To identify factors associated with neurodevelopmental delays in this population.
Main Methods:
- Scoping review of studies published in the last 10 years.
- Searched major databases using keywords: "gastroschisis," "neurodevelopment," "impairment," "motor delay," and "language delay."
- Included studies focused solely on gastroschisis, excluding other pathologies.
Main Results:
- Eleven studies were included, primarily case series (n=7), with participant ages from 12 months to 10 years.
- Findings on neurodevelopment were controversial, with some studies reporting normal development and others indicating deficiencies across domains.
- Complex gastroschisis was identified as a potential additional risk factor for neurodevelopmental delays.
Conclusions:
- Current evidence is insufficient to definitively conclude whether gastroschisis negatively impacts neurodevelopment.
- Complex gastroschisis appears to be an additional risk factor for neurodevelopmental delays.
- Prematurity and being small-for-gestation are significant confounding factors in assessing neurodevelopment; further high-quality, long-term studies are required.
Abstract:
The neurodevelopment of children with gastroschisis may be affected by intrinsic (exposure of the abdominal viscera to the amniotic fluid, causing an inflammatory reaction) and extrinsic (pain, mobility restriction, hospitalization) factors. Thus, the objective of this study was to analyze the information available in the literature on the neurodevelopment of children born with this pathology. A scoping review was done, considering as outcomes the neurodevelopment in the motor, cognitive and language domains. A search was performed in the main databases using the term "gastroschisis", associated with: "neurodevelopment", "impairment", "motor delay" and "language delay". Articles in English, published in the last 10 years, were included; but those that addressed other pathologies were excluded. Eleven studies were included, mostly case series (n = 7), with samples ranging from 14 to 88 participants and ages ranging from 12 months to 10 years. The results were controversial, some reporting normal development, and others reporting deficiencies in all domains. Complex gastroschisis can be an additional risk for neurodevelopment delays. Gastroschisis is a relatively rare malformation, but the increased survival of these children stresses the relevance of investigating short- and long-term outcomes in relation to neurodevelopment to improve the care of this population. IMPACT: This review provides a comprehensive update on neurodevelopment of children born with gastroschisis. There is insufficient evidence to support or reject the idea that gastroschisis interferes negatively with neurodevelopment, but complex gastroschisis can be an additional risk for neurodevelopment delays in this population. Prematurity and being born small-for-gestation-age are confounders factors on evaluation of neurodevelopment on children born with gastroschisis. Additional studies to obtain sufficient information size, focusing on lowering bias risk, and with longer duration of analysis, are required.
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