Department for Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.
Department for Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.
J Pediatr Surg. 2020 Nov;55(11):2293-2296. doi: 10.1016/j.jpedsurg.2019.12.018. Epub 2020 Jan 9.
Neurodevelopmental dysfunction is one of the most disabling outcomes for congenital diaphragmatic hernia (CDH) survivors and may have a long lasting impact in adult life.
To evaluate to which extent being born with CDH has an impact on the educational level and socioeconomic status as a proxy for neurocognitive development.
Nationwide, population-based prospective study of newborn children in Sweden from 1982 to 2015. School grades, highest educational level and income were assessed through Swedish public registries. Children above 15 years of age with CDH were compared with randomly selected controls.
A significantly higher number of cases (17% vs 10%) did achieve neither a school nor a university degree. Among those who achieved a degree there was no difference in the highest level of education. The qualification points in elementary school did not differ, but in high school female cases had significantly lower qualification points than female controls. There were no differences in individual disposable income between cases and controls. However, males had higher income compared to females. Prematurity and a long hospital stay had a negative impact on educational level.
A higher proportion of children born with CDH compared to controls do not achieve a school degree. Among those who achieved a degree, the school achievements and educational level were similar to controls. Prematurity and a long hospital stay are risk factors for not achieving an educational degree.
Prognosis study (high-quality prospective cohort study with 99% of patients followed to the study end point).
Level I. I for a prognosis study - This is a high-quality, prospective cohort study with 99% of patients followed to the study end point.
神经发育功能障碍是先天性膈疝（CDH）幸存者最致残的后果之一，并且可能对成年生活产生持久影响。
评估 CDH 患儿出生对教育程度和社会经济地位的影响，以作为神经认知发育的替代指标。
这是一项全国范围内、基于人群的瑞典新生儿前瞻性研究，研究时间为 1982 年至 2015 年。通过瑞典公共登记处评估学校成绩、最高教育水平和收入。将 15 岁以上患有 CDH 的儿童与随机选择的对照组进行比较。
与对照组相比，有更高比例的患儿（17%比 10%）既没有获得学校学位，也没有获得大学学位。在获得学位的人群中，最高教育水平没有差异。小学的资格分数没有差异，但高中的女病例的资格分数明显低于女对照组。病例和对照组之间的个人可支配收入没有差异。然而，男性的收入高于女性。早产和住院时间长对教育程度有负面影响。
与对照组相比，更多患有 CDH 的儿童无法获得学校学位。在获得学位的人群中，其学业成绩和教育水平与对照组相似。早产和住院时间长是无法获得学位的危险因素。
预后研究（高质量前瞻性队列研究，99%的患者随访至研究终点）。
I 级。这是一项高质量的前瞻性队列研究，99%的患者随访至研究终点。
