Martins Bianca de Moraes Rego, Souza Nathalia Cristina Oliveira de, Méio Maria Dalva Barbosa Baker, Rebelo Fernanda, Ribeiro Carla Trevisan Martins
Department of Surgery, Surgical NICU, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
Department of Neurofunctional Physiotherapy, Surgical NICU, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
Pediatr Res. 2025 May 22. doi: 10.1038/s41390-025-04139-1.
The neurodevelopment of children with gastroschisis may be affected by intrinsic (exposure of the abdominal viscera to the amniotic fluid, causing an inflammatory reaction) and extrinsic (pain, mobility restriction, hospitalization) factors. Thus, the objective of this study was to analyze the information available in the literature on the neurodevelopment of children born with this pathology. A scoping review was done, considering as outcomes the neurodevelopment in the motor, cognitive and language domains. A search was performed in the main databases using the term "gastroschisis", associated with: "neurodevelopment", "impairment", "motor delay" and "language delay". Articles in English, published in the last 10 years, were included; but those that addressed other pathologies were excluded. Eleven studies were included, mostly case series (n = 7), with samples ranging from 14 to 88 participants and ages ranging from 12 months to 10 years. The results were controversial, some reporting normal development, and others reporting deficiencies in all domains. Complex gastroschisis can be an additional risk for neurodevelopment delays. Gastroschisis is a relatively rare malformation, but the increased survival of these children stresses the relevance of investigating short- and long-term outcomes in relation to neurodevelopment to improve the care of this population. IMPACT: This review provides a comprehensive update on neurodevelopment of children born with gastroschisis. There is insufficient evidence to support or reject the idea that gastroschisis interferes negatively with neurodevelopment, but complex gastroschisis can be an additional risk for neurodevelopment delays in this population. Prematurity and being born small-for-gestation-age are confounders factors on evaluation of neurodevelopment on children born with gastroschisis. Additional studies to obtain sufficient information size, focusing on lowering bias risk, and with longer duration of analysis, are required.
腹裂患儿的神经发育可能受到内在因素（腹腔脏器暴露于羊水中，引发炎症反应）和外在因素（疼痛、活动受限、住院）的影响。因此，本研究的目的是分析文献中有关患有这种病症的儿童神经发育的可用信息。进行了一项范围综述，将运动、认知和语言领域的神经发育作为研究结果。在主要数据库中使用“腹裂”一词进行搜索，并与“神经发育”“损伤”“运动迟缓”和“语言迟缓”相关联。纳入过去10年发表的英文文章；但排除了涉及其他病症的文章。共纳入11项研究，大多为病例系列（n = 7），样本量从14至88名参与者不等，年龄从12个月至10岁。结果存在争议，一些报告显示发育正常，另一些则报告所有领域均有缺陷。复杂型腹裂可能是神经发育延迟的额外风险因素。腹裂是一种相对罕见的畸形，但这些患儿存活率的提高凸显了研究与神经发育相关的短期和长期结果以改善对这一群体护理的重要性。影响：本综述全面更新了腹裂患儿神经发育的相关信息。目前尚无足够证据支持或反驳腹裂会对神经发育产生负面影响这一观点，但复杂型腹裂可能是该群体神经发育延迟的额外风险因素。早产和小于胎龄儿是评估腹裂患儿神经发育的混杂因素。需要开展更多研究以获得足够的样本量，注重降低偏倚风险，并进行更长时间的分析。
