The long-term neurodevelopmental and psychological outcomes of gastroschisis: A cohort study.
OBJECTIVE
Previous gastroschisis specific neurodevelopmental studies have focused on the first 3years of life. The aim of this study was to assess the intellectual, behavioral and neurological outcomes of older children and adolescents born with gastroschisis.


METHODS
Of 99 gastroschisis survivors born in Western Australia, 1992 to 2005, and who were at least 5years old, 42 agreed to take part in this study. The study assessed: intellectual ability, with age appropriate Wechsler intelligence scales; neurological status; hearing; vision; behavioral status with the Strengths and Difficulties Questionnaire (SDQ); and parenting style with the Parenting Relationship Questionnaire (PRQ). All results were compared to normative means.


RESULTS
Median age at follow-up was 10years (range 5-17). No child had evidence of cerebral palsy or hearing loss; 1 child had amblyopia. Psychometric tests were completed in 39 children: mean full scale IQ was 98.2 (standard deviation [SD] 10.7); the working memory index was the only subscale to show a significant decrease from the normative mean (mean 95.5, SD 12.4, p=0.038). The mean SDQ behavioral scores were significantly lower for 3 of 5 domains and the Total Difficulties score. PRQ scores were significantly abnormal for 4 of 7 domains: Communication, Discipline, Satisfaction with School and Relational Frustration.


CONCLUSIONS
Overall intellectual abilities were within a normal range. The decrease in working memory index and the behavioral and parenting relationship impairments could be an effect of perinatal factors, gastroschisis management and complications or the complexity of the socio-economic environment.
Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women, Perth, WA, Australia; Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, WA, Australia; Biostatistics Unit, Women and Infants Research Foundation, Perth, WA, Australia.
Emma L
EL
Harris
Biostatistics Unit, Women and Infants Research Foundation, Perth, WA, Australia; School of Women's and Infants' Health, The University of Western Australia, Perth, WA, Australia.
Susannah J
SJ
Hart
Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, WA, Australia. Electronic address: cminutillo53@gmail.com.
Corrado
C
Minutillo
Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, WA, Australia.
Madur
M
Ravikumara
Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women, Perth, WA, Australia; School of Women's and Infants' Health, The University of Western Australia, Perth, WA, Australia.
Teresa M
TM
Warner
Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, WA, Australia.
Yvette
Y
Williams
Biostatistics Unit, Women and Infants Research Foundation, Perth, WA, Australia; School of Women's and Infants' Health, The University of Western Australia, Perth, WA, Australia.
Elizabeth A
EA
Nathan
Biostatistics Unit, Women and Infants Research Foundation, Perth, WA, Australia; School of Women's and Infants' Health, The University of Western Australia, Perth, WA, Australia.
Jan E
JE
Dickinson
D000293:Adolescent; D000294:Adolescent Behavior; D041923:Adolescent Development; D002648:Child; D002652:Child Behavior; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000150:complications* / Q000523:psychology; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D009483:Neuropsychological Tests; D011594:Psychometrics; D011795:Surveys and Questionnaires; D014904:Western Australia
Adolescent; Child; Congenital; Gastroschisis; Infant; Intellect; Neurodevelopment; Outcome studies; Psychology; Questionnaires; Surgery