Quality of Life Outcomes in Children Following Surgical Management of Gastroschisis: A Systematic Review and Meta-analysis.

BACKGROUND

The quality of life of pediatric patients born with gastroschisis has yet to be documented in a systematic review. Our objective is to quantitatively summarize the parent and child-reported quality of life outcomes of children born with gastroschisis.

METHODS

Records were sourced from the MEDLINE, PsycInfo, EBM Reviews, and Embase databases. Studies that examined child and parent-reported quality of life outcomes in pediatric patients with gastroschisis were included. Screening and data extraction was conducted by three reviewers. The primary outcome was the reported quality of life functioning scores, and the secondary outcomes included gastrointestinal symptoms and nutritional limitations. A random effects meta-analysis and sensitivity analysis were performed.

RESULTS

2695 articles were screened, and eight studies were included. Pooled parent-reported quality of life mean estimate scores were higher in the realms of physical and emotional functioning, with lower psychosocial and school functioning scores. Child-reported pooled standardized mean scores showed higher perceived physical functioning and social functioning with lower emotional and school functioning scores. Pooled parent-reported gastrointestinal symptom mean estimate scores showed higher heartburn and reflux, difficulty swallowing, nausea and vomiting, diarrhea, and food and drink limitation scores, representing improved clinical outcomes in those domains. Lower scores were noted in the domains of abdominal pain and constipation, indicating worse clinical outcomes in these domains.

CONCLUSION

The pediatric gastroschisis population has better quality of life scores in physical functioning with poorer abdominal pain and constipation scores. These symptoms should be highlighted when counselling the parents of these patients.

LEVEL OF EVIDENCE: V.

TYPE OF STUDY: Reviews, Systematic Reviews, Meta-Analyses, and Guidelines.