title: Neurodevelopment and Health-Related Quality of Life in Infants Born with Gastroschisis: A 6-Year Retrospective French Study.
abstract: IntroductionQuantify quality of life (QoL) outcomes in gastroschisis children is little assessed. The primary objective was to describe the long-term outcome of newborns with gastroschisis treated in three tertiary care hospitals of France in terms of neurodevelopment and QoL.Materials and MethodsThe study reported was a cross-sectional, descriptive multicentric retrospective study assessing the outcome of newborns with gastroschisis, born between January 1, 2009, and December 31, 2014, treated at two large and French level III neonatal intensive care units. Long-term outcome data were assessed by questionnaires sent to the infants' parents. Questionnaires explored global health, neurological development, and quality of life (overall assessment including socio-economic and medical), Age & Stages Questionnaire, infants' quality of life (KIDSCREEN), and quality of parents' life (General Questionnaire Short Form-36).ResultsIn this study, 50% of the survivor's families answered the assessment form (n= 33). The average follow-up age was 40 months, ranging from 8 months to 6 years. Cases of simple gastroschisis more often had a normal score for "communication" (p= 0.033), while patients who received morphine for a longer duration had significantly lower scores for the items "communication" and "problem resolving" (p= 0.024 andp= 0.011, respectively). Children's QoL was significantly lower for patients with gestational age younger than 36 weeks (p= 0.023) and for patients born following "fetal cause delivery" (p= 0.022). Parents had a significantly higher physical composite score if their child underwent primary closure (p= 0.012).ConclusionOur analyses confirm the idea that cases of complex gastroschisis and preterm delivery may lead to poorer outcome. Such hindsight (40 months in mean) allowed for an interesting assessment of development long after the patient's initial hospitalization and to confirm these results, a standardized neuropsychological evaluation of patients should be done when at least 6 years old. An accurate assessment of the social environment and its impact on the development and QoL of children will be fundamental to avoid selection bias.
authors.affiliation: Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France.
authors.forename: Barthelemy
authors.initials: B
authors.lastname: Tosello
authors.affiliation: Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France.
authors.forename: Meriem
authors.initials: M
authors.lastname: Zahed
authors.affiliation: Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France.
authors.forename: Floriane
authors.initials: F
authors.lastname: Guimond
authors.affiliation: Department of Epidemiology, Aix-Marseille Universite Faculte de Medecine, Marseille, Provence-Alpes-Côte d'Azu, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.affiliation: Department of Pediatric Surgery, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Faure
authors.affiliation: Department of Pediatric Intensive Care Unit, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Michel
authors.affiliation: Department of Neonatology, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Claris
authors.affiliation: Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Massardier
authors.affiliation: Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Gire
authors.affiliation: Department of Pediatric Surgery, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Merrot
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D020139:Gastroschisis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D065886:Neurodevelopmental Disorders / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies