title: Early developmental assessment of children with major non-cardiac congenital anomalies predicts development at the age of 5 years.
abstract: OBJECTIVE
  the aim of this study was to evaluate cognitive and motor development in children with major congenital anomalies and the predictability of development at age 5 years.
  
  
  METHODS
  a prospective, longitudinal follow-up study was undertaken. The Dutch version of the Bayley Scales of Infant Development - Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) - were administered at the ages of 6, 12, and 24 months. The Revised Amsterdam Children's Intelligence Test - IQ and the Movement Assessment Battery for Children - Total impairment score (TIS) were used at age 5 years. A total of 117 children participated in the study. After excluding 12 children who had a major chromosomal or syndromal abnormality, the analysis was limited to 105 children (50 females, 55 males). Seven groups of congenital anomalies were distinguished: (1) small intestinal anomalies; (2) abdominal wall defects, comprising gastroschisis and omphalocele; (3) oesophageal atresia; (4) congenital diaphragmatic hernia; (5) Hirschsprung disease; (6) anorectal malformations; and (7) miscellaneous diagnoses. Logistic regression analyses served to determine the ability of MDI and PDI to predict IQ and TIS at age 5 years.
  
  
  RESULTS
  at age five, 83.7% of 104 children had an IQ of 85 or above and 16.3% an IQ of less than 85. TIS was normal in 71.3% of 87 children, while 17.2% demonstrated a borderline score and 11.5% a definite motor problem. MDI and PDI scores showed equal sensitivity to predict IQ (p=0.004 at 6 and 12mo, p=0.001 at 24mo) and TIS (p<0.001 at 6 and 12mo, p=0.002 at 24mo). MDI and PDI were positively correlated with IQ and TIS; TIS was positively correlated with IQ.
  
  
  CONCLUSIONS
  IQ scores at 5 years of age corresponded to Dutch population scores, but TIS scores differed significantly. Early development of children with major congenital anomalies is predictive of development at 5 years, which can guide individualized follow-up for this vulnerable group of children.
authors.affiliation: Department of Paediatric Surgery, Erasmus MC, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, Netherlands. p.mazer@erasmusmc.nl
authors.forename: Petra
authors.initials: P
authors.lastname: Mazer
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Gischler
authors.forename: Monique H M
authors.initials: MH
authors.lastname: VAN DER Cammen-VAN Zijp
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Nicolaas M A
authors.initials: NM
authors.lastname: Bax
authors.forename: Hanneke
authors.initials: H
authors.lastname: Ijsselstijn
authors.forename: Monique
authors.initials: M
authors.lastname: VAN Dijk
authors.forename: Hugo J
authors.initials: HJ
authors.lastname: Duivenvoorden
mesh_terms: D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D003710:Demography; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology*; D013223:Statistics as Topic; D013997:Time Factors