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Early developmental outcome following surgery for oesophageal atresia

Authors

  • Karen Walker,

    Corresponding author
    1. Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, New South Wales, Australia
    2. Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia
    • Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, Australia
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  • Robert Halliday,

    1. Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, Australia
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  • Nadia Badawi,

    1. Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, Australia
    2. Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, New South Wales, Australia
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  • Jan Stewart,

    1. Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, Australia
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  • Andrew JA Holland

    1. Douglas Cohen Department of Paediatric Surgery, The Children's Hospital at Westmead, Westmead, Australia
    2. Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, New South Wales, Australia
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  • Conflict of interest: None declared.

Correspondence: Dr Karen Walker, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. Fax: +61 2 9845 1923; email: karen.walker@health.nsw.gov.au

Abstract

Aim

To compare the developmental outcome of infants with oesophageal atresia with or without trachea-oesophageal fistula (OA/TOF) who underwent surgery in early infancy with healthy control infants in New South Wales, Australia.

Methods

Infants diagnosed with OA/TOF requiring surgical intervention were enrolled prospectively between 1 August 2006 and the 31 December 2008. Healthy control infants were enrolled in the same time period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development (Version III).

Results

Of 34 infants with OA/TOF that were enrolled, 31 had developmental assessments. The majority (75%) were term infants (≥37 weeks gestation) with a mean birth weight of 2717 g. Fourteen infants (44%) had an associated birth defect and one infant with multiple associated anomalies subsequently died. Developmental assessments were also performed on 62 control infants matched for gestational age. Infants with OA/TOF had a mean score significantly lower on the expressive language subscale (P < 0.05) compared with the control infants.

Conclusions

This study found a lower than expected developmental score for infants following surgery for OA/TOF in the expressive language subscale compared with the healthy control infants. These findings support concerns over the potential impact of OA/TOF and its effects on development. Further studies, including continuing developmental review to determine whether these differences persist and their functional importance, should be performed.

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