Neurodevelopmental outcomes of infants with esophageal atresia and tracheoesophageal fistula

作者：Mawlana Wegdan; Zamiara Paul; Lane Hilary; Marcon Margaret; Lapidus Krol Eveline; Chiu Priscilla P L; Moore Aideen M^*

来源：Journal of Pediatric Surgery, 2018, 53(9): 1651-1654.

DOI：10.1016/j.jpedsurg.2017.12.024

• Esophageal atresia
• EA/TEF
• Outcomes
• Neurodevelopment

Background: Esophageal atresia with or without tracheoesophageal fistula (EAJFEF) is a complex disorder, and most outcome data are confined to mortality and feeding-related morbidities. Our objective was to examine mortality, growth and neurodevelopmental outcomes in a large recent cohort of infants with E.A/IEF.
Methods: Single center study of EA/TEF infants referred from January 2000 to December 2015. Data collected included associated defects, neonatal morbidity and mortality and growth and neurodevelopmental outcomes at age 12-36 months. Multiple regression analysis was used to determine variables associated with adverse outcome.
Results: Of the 253 infants identified, 102 infants (40%) were preterm. Overall mortality was 8.3%, the majority from major cardiac malformations (p < 0.001) Neurodevelopmental assessments (n - 182) showed that 76% were within normal, while some delay was seen in 24%, most often in expressive and receptive language. Nine infants had hearing impairment and 5 had visual impairment. Gastrostomy tubes were required in 47 patients and 15% continued to have weight growth velocities less than the 10th centile. A number of specialist interventions were required, Speech/Language being frequent.
Conclusion: Mortality in EA/TEF is primarily related to concomitant anomalies, especially cardiac. Multidisciplinary follow up is important for early identification and intervention for growth failure and developmental delay.

• 出版日期2018-9