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Early developmental assessment of children with major non‐cardiac congenital anomalies predicts development at the age of 5 years
Author(s) -
MAZER PETRA,
GISCHLER SASKIA J,
VAN DER CAMMENVAN ZIJP MONIQUE H M,
TIBBOEL DICK,
BAX NICOLAAS M A,
IJSSELSTIJN HANNEKE,
VAN DIJK MONIQUE,
DUIVENVOORDEN HUGO J
Publication year - 2010
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2010.03772.x
Subject(s) - bayley scales of infant development , pediatrics , psychomotor learning , congenital diaphragmatic hernia , medicine , omphalocele , intelligence quotient , abnormality , wechsler preschool and primary scale of intelligence , gastroschisis , prospective cohort study , wechsler intelligence scale for children , cognition , pregnancy , fetus , genetics , psychiatry , biology
Aim The aim of this study was to evaluate cognitive and motor development in children with major congenital anomalies and the predictability of development at age 5 years. Method A prospective, longitudinal follow‐up study was undertaken. The Dutch version of the Bayley Scales of Infant Development – Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) – were administered at the ages of 6, 12, and 24 months. The Revised Amsterdam Children’s Intelligence Test – IQ and the Movement Assessment Battery for Children – Total impairment score (TIS) were used at age 5 years. A total of 117 children participated in the study. After excluding 12 children who had a major chromosomal or syndromal abnormality, the analysis was limited to 105 children (50 females, 55 males). Seven groups of congenital anomalies were distinguished: (1) small intestinal anomalies; (2) abdominal wall defects, comprising gastroschisis and omphalocele; (3) oesophageal atresia; (4) congenital diaphragmatic hernia; (5) Hirschsprung disease; (6) anorectal malformations; and (7) miscellaneous diagnoses. Logistic regression analyses served to determine the ability of MDI and PDI to predict IQ and TIS at age 5 years. Results At age five, 83.7% of 104 children had an IQ of 85 or above and 16.3% an IQ of less than 85. TIS was normal in 71.3% of 87 children, while 17.2% demonstrated a borderline score and 11.5% a definite motor problem. MDI and PDI scores showed equal sensitivity to predict IQ ( p =0.004 at 6 and 12mo, p =0.001 at 24mo) and TIS ( p <0.001 at 6 and 12mo, p =0.002 at 24mo). MDI and PDI were positively correlated with IQ and TIS; TIS was positively correlated with IQ. Interpretation IQ scores at 5 years of age corresponded to Dutch population scores, but TIS scores differed significantly. Early development of children with major congenital anomalies is predictive of development at 5 years, which can guide individualized follow‐up for this vulnerable group of children.