A multicenter study of school functioning in children with Hirschsprung disease in China: a cross-sectional propensity-score-matched analysis.

PURPOSE: To compare school functioning (SF) in children with Hirschsprung disease (HSCR) versus healthy controls. METHODS: A cross-sectional study of HSCR patients aged 7–14 years post-definitive surgery conducted across three Chinese centers (Oct 2024–May 2025) using a self-report survey. The survey employed three validated instruments: the SF domain of the PedsQL 4.0, the Delaware Bullying Victimization Scale and the Rintala Bowel Function Scale. RESULTS: After propensity-score-matching (1:1 matching, 207 vs. 207), HSCR students were found to perform significantly worse in Mathematics compared to controls (41.1% vs. 54.6% obtaining Grade A, p = 0.005), but not in Chinese. The overall SF scores in the HSCR group were significantly lower than those in controls [Median 95 (IQR 85–100) vs. 100 (90–100), respectively, p<0.001]. There was a higher prevalence of bullying in controls compared to HSCR participants, although the absolute number of bullying exposure was low (22 control and 8 HSCR out of 207 respectively). Risk factors for lower SF include ‘left-behind children’, unemployed mothers, and abnormal BF. CONCLUSIONS: Students with HSCR had lower BF and SF scores and were less likely to achieve high scores in Mathematics. We suggest that children with HSCR may benefit from targeted academic support, and greater parental engagement.