Complex trajectories are associated with neurological impairment in infants with congenital gastrointestinal malformations aged two.

Abstract

Our aims were to describe the neurodevelopment of infants with congenital gastrointestinal malformations at 2 years of age and to investigate the association between developmental delay and complex trajectories. We conducted a retrospective cohort study. Infants operated on for oesophageal atresia, abdominal wall defects, intestinal malformation, congenital diaphragmatic hernia and anorectal malformation were analysed. Neurodevelopment was assessed using the Ages and Stages Questionnaire at 24 months. The primary outcome was the presence of developmental delay, defined as ASQ-24 months of total score ≤ 185. Of 118 patients, 11 (9%) had an ASQ-24 months ≤185. Factors associated with an ASQ-24 months ≤185 were earlier gestational age (p = 0.045), longer invasive ventilation (p = 0.046), longer parenteral nutrition (p = 0.043) and ≥2 hospitalisations in the first 2 years (p = 0.022). They had a significantly longer stay in the neonatal intensive care unit and subsequent hospitalisations (p = 0.007). After adjustment for prematurity and breastfeeding, this association remained statistically significant. Nine per cent of children with a gastrointestinal malformation show a developmental delay at the age of two. A prolonged stay in the neonatal intensive care unit and subsequent hospitalisations are associated with an increased risk of neurodevelopmental disorders, while breastfeeding may have a protective effect.