title: Prospective long-term follow up of children with anorectal malformation: growth and development until 5years of age.
abstract: OBJECTIVE
  To evaluate growth and development in children with anorectal malformations and to analyze effects of type of malformation and comorbidities.
  
  
  METHODS
  Non-syndromal children with anorectal malformations were prospectively evaluated at 0.5, 1, 2, and 5 years. Biometrics were obtained at all visits. Mental and psychomotor function development was determined.
  
  
  RESULTS
  108 children (59% male) were included. 49% had a high malformation, and 46% had ≥ 1 additional major comorbidity. All growth parameters were below the norm at all ages (p<0.01), irrespective of type of malformation. Children with ≥ 1 additional major anomaly had lower height at all ages; at 5 years, mean (95% CI) height was -1.83 (-2.7 to -1.1) and -0.70 (-1.3 to -0.1) in children with and without comorbidities, respectively (p=0.019). Mental development was normal, irrespective of the type of malformation or comorbidities. Motor development was delayed at all ages. At 5 years, motor development (n=30) was normal in 70%, borderline in 23%, and 7% had definitive motor problems (p=0.043).
  
  
  CONCLUSIONS
  Non-syndromal children with anorectal malformations are at risk for growth impairment, especially those with additional major comorbidity. Mental development is normal. Motor development is slightly impaired. Supportive care should focus on growth, dietary management, and motor development besides defecation problems.
authors.affiliation: Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, 3000 CB, Rotterdam, the Netherlands.
authors.forename: Desiree
authors.initials: D
authors.lastname: van den Hondel
authors.forename: Cornelius E J
authors.initials: CE
authors.lastname: Sloots
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Gischler
authors.forename: Conny J H M
authors.initials: CJ
authors.lastname: Meeussen
authors.forename: Rene M H
authors.initials: RM
authors.lastname: Wijnen
authors.forename: Hanneke
authors.initials: H
authors.lastname: IJsselstijn
mesh_terms: D001003:Anal Canal / Q000002:abnormalities*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D015897:Comorbidity; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012007:Rectum / Q000002:abnormalities*; D012307:Risk Factors; D018709:Statistics, Nonparametric