Developmental problems in patients with oesophageal atresia: a longitudinal follow-up study

OBJECTIVE: To longitudinally evaluate motor development and predictive factors in school-age children with oesophageal atresia. DESIGN: Cohort study with prospective longitudinal follow-up. SETTING: Outpatient clinic of a tertiary university paediatric hospital. PATIENTS: Children with oesophageal atresia born between January 1999 and May 2006 were assessed at 5 and 8 years of age. INTERVENTIONS: None. MAIN OUTCOME: Motor performance was evaluated at 5 and 8 years using the Movement Assessment Battery for Children (M-ABC). Additionally, we evaluated perinatal characteristics, duration of anaesthesia within the first 24 months, socioeconomic status, sports participation and school performance at time of follow-up and intelligence and sustained attention at the age of 8 years. RESULTS: In 5-year-olds (n=54), the mean (SD) z-score M-ABC was slightly, but significantly lower than age-predicted normative values (-0.75 (0.83), p<0.001). In 8-year-olds (n=49), the z-score M-ABC was -0.53 (0.91) (p<0.001), intelligence was normal, but sustained attention was impaired: z-score speed (-1.50 (1.73)) and raw score attentional fluctuation (3.99 (1.90)) (both p<0.001). Motor problems mainly concerned gross motor performance. Duration of anaesthesia and sustained attention were negatively associated with motor development; sports participation was positively associated. CONCLUSIONS: Longer duration of anaesthesia and sustained attention problems were associated with gross motor problems in school-age patients with oesophageal atresia. Parental awareness of risks for motor problems may provide the opportunity to offer timely intervention.