Pediatric surgery international · 2025
Neurodevelopmental disorders in children with congenital abdominal wall defects: a national population-based study.
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Fogelström Anna, Skoglund Charlotte, Hagel Eva, Wester Tomas, Löf Granström Anna, Mesas-Burgos Carmen
Аннотация
PURPOSE: One in 4000 Swedish children is born with abdominal wall defect (AWD). Little is known about their neurodevelopmental trajectory and long-term morbidity. The aim was to determine the risk of neurodevelopmental disorders in children born with omphalocele or gastroschisis.
METHODS: This was a population-based national cohort study including children born with omphalocele or gastroschisis in Sweden 1997-2016. Individuals with chromosomal abnormality were excluded. Ten age and sex-matched unexposed individuals were randomly selected for every AWD case. Main outcomes were autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Data were collected from the national health registers.
RESULTS: During the study period, 496 children were born with AWD and included in the exposed cohorts. The unexposed cohorts consisted of 4943 children. Neurodevelopmental diagnoses were found in 11 (6.1%) children with omphalocele and 15 (4.8%) children with gastroschisis compared to 63 (3.5%) and 113 (3.6%) in the unexposed cohorts (p = 0.096 and p = 0.275). Children with omphalocele had higher risk of ASD (HR = 3.51, 95% CI 1.59-7.78) than unexposed peers (p = 0.02). There was no significant difference in ADHD incidence.
CONCLUSIONS: Children with AWD may have similar risk of ADHD as age- and sex-matched peers. While the omphalocele cohort had a higher incidence of ASD, the overall incidence remained relatively low.
LEVEL OF EVIDENCE: II.
METHODS: This was a population-based national cohort study including children born with omphalocele or gastroschisis in Sweden 1997-2016. Individuals with chromosomal abnormality were excluded. Ten age and sex-matched unexposed individuals were randomly selected for every AWD case. Main outcomes were autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Data were collected from the national health registers.
RESULTS: During the study period, 496 children were born with AWD and included in the exposed cohorts. The unexposed cohorts consisted of 4943 children. Neurodevelopmental diagnoses were found in 11 (6.1%) children with omphalocele and 15 (4.8%) children with gastroschisis compared to 63 (3.5%) and 113 (3.6%) in the unexposed cohorts (p = 0.096 and p = 0.275). Children with omphalocele had higher risk of ASD (HR = 3.51, 95% CI 1.59-7.78) than unexposed peers (p = 0.02). There was no significant difference in ADHD incidence.
CONCLUSIONS: Children with AWD may have similar risk of ADHD as age- and sex-matched peers. While the omphalocele cohort had a higher incidence of ASD, the overall incidence remained relatively low.
LEVEL OF EVIDENCE: II.