DOZ047.26: Longitudinal motor development from infancy to adolescence in children with esophageal atresia

Abstract

Abstract Introduction Motor performance may be affected in children with esophageal atresia (EA), but the development of motor performance from infancy to adolescence has not been properly studied. We have followed EA patients from one to 15 years of age and assessed development of motor performance. Methods Of 44 EA patients, born 1999–2002, 3 died, 6 with missing data, 4 excluded, and 10 refused to participate. Of 21 children were included. Perinatal data collected from medical records, and physical therapy was registered. The children were evaluated with The Bayley Scale of Infant Development-Second Edition at one year of age, and re-evaluated in adolescence with The Motor Assessment Battery for Children Second Edition. Both tests are well validated for fine and gross motor performance. The motor performances was categorized as normal, at risk or delayed at both evaluations. Results Of 21 EA children (GA 38.7, range: 34–40.7), 4 (19%) were premature, 18 (86%) had Gross type C, major cardiac anomaly in 1, VACTERL in 4 (19%). At 15.1 months, 19/21 (90%) had motor performance within normal range, 1 child had delayed motor performance, and 1 child at risk for motor delay. At 15 years 15/21 (71%) had motor performance within normal range, 3/21 (14%) children showed delayed motor performance and 3/21 (14%) at risk for motor delay. 5/21 (24%) EA patients had deteriorated and 1/21 (5%) remained delayed in motor performance, when grown up from 1 to 15 years of age. The gross motor function most often affected in adolescence was the balance skills. Impaired motor performance was correlated to prematurity (r = .499, P = .021), but not to other perinatal morbidity factors. The EA patients had not been offered systematic follow-up physical therapy program during childhood. Conclusion Motor performance was within normal range in 90% of the EA infants, but in adolescence, only 71% of the patients showed normal motor performance. However, at one year of age it is hard to distinguish the children who have mild motor delay. Close monitoring in childhood might help to diagnose them earlier and offer appropriate intervention.