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Neurodevelopmental disorders in children with congenital abdominal wall defects: a national population-based study

Anna Fogelström1,2, Charlotte Skoglund3, Eva Hagel4

  • 1Division of Pediatric Surgery, Astrid Lindgren Children's Hospital, C11:33, Karolinska University Hospital, 17176, Stockholm, Sweden. anna.fogelstrom@ki.se.

Pediatric Surgery International
|September 22, 2025
PubMed

Insights

Children born with abdominal wall defects (AWD) have a higher risk of autism spectrum disorder (ASD), particularly those with omphalocele. However, the risk for attention-deficit/hyperactivity disorder (ADHD) is similar to peers.

Area of Science:

  • Pediatric Surgery
  • Developmental Pediatrics
  • Public Health

Background:

  • Abdominal wall defects (AWD), including omphalocele and gastroschisis, affect approximately 1 in 4000 Swedish newborns.
  • Long-term neurodevelopmental outcomes and morbidity in children with AWD are not well-understood.

Purpose of the Study:

  • To investigate the risk of neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), in children born with omphalocele or gastroschisis.

Main Methods:

  • Population-based national cohort study in Sweden (1997-2016).
  • Included children with omphalocele or gastroschisis, excluding those with chromosomal abnormalities.
  • Matched 10 unexposed individuals for each AWD case.
  • Utilized national health registers for data collection on ASD and ADHD diagnoses.

Main Results:

  • The omphalocele cohort showed a significantly higher risk of ASD (HR=3.51) compared to unexposed peers (p=0.02).
  • No significant difference in the incidence of ADHD was observed between AWD cohorts and unexposed controls.
  • Overall incidence of neurodevelopmental disorders remained relatively low despite increased risk in specific subgroups.

Conclusions:

  • Children with AWD generally have a similar risk of ADHD as their peers.
  • Omphalocele is associated with an increased incidence of ASD, although the overall rate is low.
  • Further research into long-term neurodevelopmental trajectories for AWD patients is warranted.
Abstract

Keywords:
ADHDAutismExomphalosGastroschisisNeurodevelopmental disorderOmphalocele

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