Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Sci Rep. 2024 Oct 8;14(1):23442. doi: 10.1038/s41598-024-74515-0.
This study investigated neurodevelopment and risk factors in children surgically treated for congenital gastrointestinal anomalies (CGIA), excluding those with known high-risk factors such as low birth weight or chromosomal anomalies. Data of children born between 2008 and 2015 who underwent surgical treatment for CGIA were retrieved from the Korean National Health Insurance Database. CGIA included esophageal atresia, duodenal atresia, jejunoileal atresia, anorectal malformations, and congenital megacolon. Neurodevelopmental impairment (NDI) was defined as Korean Ages and Stages Questionnaire scores below the determined cut-off or Korean Developmental Screening Test scores < 2 standard deviations at 3 years of age. Children with CGIA had a significantly higher risk of NDI than controls (6.2% vs. 2.7%, p < 0.001). Growth failure was correlated with NDI. Longer durations of oxygen support (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.013-1.063), mechanical ventilation (aOR, 1.053; 95% CI, 1.018-1.089), and number of surgeries (aOR, 1.137; 95% CI, 1.016-1.273) were significantly associated with NDI. These findings emphasize that cautious yet proactive neurodevelopmental monitoring is crucial in affected children, ensuring timely intervention and that excessive concern among families is unnecessary.
本研究调查了接受先天性胃肠道畸形(CGIA)手术治疗的儿童的神经发育和风险因素,不包括那些具有已知高风险因素(如低出生体重或染色体异常)的儿童。从韩国国家健康保险数据库中检索了 2008 年至 2015 年间出生并接受 CGIA 手术治疗的儿童数据。CGIA 包括食管闭锁、十二指肠闭锁、空肠回肠闭锁、肛门直肠畸形和先天性巨结肠。神经发育障碍(NDI)定义为 3 岁时韩国年龄和阶段问卷评分低于确定的截断值或韩国发育筛查测试评分 < 2 个标准差。患有 CGIA 的儿童发生 NDI 的风险明显高于对照组(6.2% vs. 2.7%,p < 0.001)。生长不良与 NDI 相关。较长时间的氧气支持(调整优势比 [aOR],1.037;95%置信区间 [CI],1.013-1.063)、机械通气(aOR,1.053;95% CI,1.018-1.089)和手术次数(aOR,1.137;95% CI,1.016-1.273)与 NDI 显著相关。这些发现强调,在受影响的儿童中,谨慎但积极的神经发育监测至关重要,确保及时干预,同时也不必让家庭过度担忧。