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Eur J Pediatr Surg 2017; 27(04): 352-360
DOI: 10.1055/s-0036-1597268
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Neurodevelopment and Health-Related Quality of Life in Infants Born with Gastroschisis: A 6-Year Retrospective French Study

Barthelemy Tosello
1   Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France
,
Meriem Zahed
1   Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France
,
Floriane Guimond
1   Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France
,
Karine Baumstarck
2   Department of Epidemiology, Aix-Marseille Universite Faculte de Medecine, Marseille, Provence-Alpes-Côte d'Azu, France
,
Alice Faure
3   Department of Pediatric Surgery, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France
,
Fabrice Michel
4   Department of Pediatric Intensive Care Unit, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France
,
Olivier Claris
5   Department of Neonatology, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France
,
Jerome Massardier
6   Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France
,
Catherine Gire
1   Department of Neonatology, Assistance Publique Hopitaux de Marseille, Marseille, France
,
Thierry Merrot
3   Department of Pediatric Surgery, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France
› Author Affiliations
Further Information

Publication History

15 September 2016

26 October 2016

Publication Date:
08 December 2016 (online)

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Abstract

Introduction Quantify 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 Methods The 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).

Results In 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 and p = 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).

Conclusion Our 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.

Keywords

gastroschisis - neurodevelopmental - outcome - quality of life
 

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