Neurodevelopmental outcomes of infants with esophageal atresia and tracheoesophageal fistula |
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Authors: | Wegdan Mawlana Paul Zamiara Hilary Lane Margaret Marcon Eveline Lapidus-Krol Priscilla PL Chiu Aideen M Moore |
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Affiliation: | 1. Department of Pediatrics, Tanta University Hospital, Tanta, Egypt;2. Division of General and Thoracic Surgery, The Hospital for Sick Children, and University of Toronto, Toronto, ON, Canada;3. Division of Gastroenterology, Hepatology and Nutrition and Department of Pediatrics, The Hospital for Sick Children, and University of Toronto, Toronto, ON, Canada;4. Division of Neonatology, and Department of Pediatrics, The Hospital for Sick Children, and University of Toronto, Toronto, ON, Canada |
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Abstract: | BackgroundEsophageal atresia with or without tracheoesophageal fistula (EA/TEF) 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 EA/TEF.MethodsSingle 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.ResultsOf 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.ConclusionMortality 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.Type of studyRetrospective studyLevel of evidenceLevel II |
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Keywords: | EA/TEF esophageal atresia/tracheoesophageal fistula Esophageal atresia EA/TEF Outcomes Neurodevelopment |
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