Burnett Alice C, Gunn Julia K, Hutchinson Esther A, Moran Margaret M, Kelly Lisa M, Sevil Ursula C, Anderson Peter J, Hunt Rod W
Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Premature Infant Follow-Up Programme, Royal Women's Hospital, Melbourne, Australia.
Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neonatal Research, Murdoch Childrens Research Institute, Melbourne, Australia.
Early Hum Dev. 2018 Jan;116:47-52. doi: 10.1016/j.earlhumdev.2017.11.002. Epub 2017 Nov 11.
To characterise neurodevelopment at age two years and cognition and behaviour at age five years in children born with abdominal wall defects (gastroschisis or exomphalos).
Participants were treated as neonates for gastroschisis or exomphalos and invited for routine clinical follow-up at ages two and five years. Thirty-nine two year-olds and 20 five year-olds with gastroschisis and 20 two year-olds and 10 five year-olds with exomphalos returned for age-appropriate assessments of development (two years) and intellectual functioning (IQ), executive function, and behavioural problems. Results were compared with normative data from the tests and published data from local term-born children.
For both gastroschisis and exomphalos two year-olds, neurodevelopment was in line with the test normative data, but below the level of local normative data for all domains (effect sizes from -0.4 to -1.4 standard deviations). At five years, children with gastroschisis performed similarly to the normative mean for IQ but had high rates of various executive functioning problems on parent report (18-41% compared with 7% expected from norms). There was also a tendency for increased frequency of internalising problems (33% compared with normative expectation of 16%). Five year-olds with exomphalos also performed similarly to the normative mean for IQ and had low rates of executive and behavioural problems.
Survivors of gastroschisis and exomphalos may be at risk of poor neurodevelopment in toddlerhood, depending on the reference group, and children with gastroschisis may be particularly at risk for executive functioning difficulties despite an IQ within normal limits.
描述腹壁缺损（腹裂或脐膨出）患儿两岁时的神经发育情况以及五岁时的认知和行为表现。
参与者在新生儿期接受了腹裂或脐膨出治疗，并被邀请在两岁和五岁时进行常规临床随访。39名两岁腹裂患儿、20名五岁腹裂患儿、20名两岁脐膨出患儿和10名五岁脐膨出患儿返回接受了适合其年龄的发育评估（两岁时）以及智力功能（智商）、执行功能和行为问题评估。将结果与测试的标准数据以及本地足月儿的已发表数据进行比较。
对于两岁的腹裂和脐膨出患儿，神经发育符合测试标准数据，但在所有领域均低于本地标准数据水平（效应大小为-0.4至-1.4个标准差）。五岁时，腹裂患儿的智商表现与标准均值相似，但家长报告显示各种执行功能问题的发生率较高（18%-41%，而标准预期为7%）。内化问题的发生频率也有增加的趋势（33%，而标准预期为16%）。五岁的脐膨出患儿智商表现也与标准均值相似，执行和行为问题发生率较低。
腹裂和脐膨出的幸存者在幼儿期可能存在神经发育不良的风险，具体取决于参照组，并且腹裂患儿尽管智商在正常范围内，但执行功能困难的风险可能特别高。
