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Childhood Educational Outcomes of Children Born with Gastroschisis - 21/12/21

Doi : 10.1016/j.jpeds.2021.08.086 
Nahed O. ElHassan, MD, MPH 1, 2, , Megha Sharma, MD 1, Chary Akmyradov, PhD 3, Jeffrey R. Kaiser, MD, MA 4, 5, Anthony Goudie, PhD 6, Wendy N. Nembhard, PhD 2, 7
1 Department of Pediatrics, Arkansas Children’s Hospital, University of Arkansas for Medical Sciences, Little Rock, AR 
2 Arkansas Center for Birth Defects Research and Prevention, Little Rock, AR 
3 Arkansas Children’s Research Institute, Little Rock, AR 
4 Department of Pediatrics, Penn State Children’s Hospital, Hershey, PA 
5 Department of Obstetrics and Gynecology, Penn State Children’s Hospital, Hershey, PA 
6 Department of Health Policy and Management, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock, AR 
7 Department of Epidemiology, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock, AR 

Address for correspondence: Nahed O. ElHassan, MD, MPH, Department of Pediatrics (Neonatology), University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, 1 Children’s Way, Slot 512-5, Little Rock, AR 72202Department of Pediatrics (Neonatology)University of Arkansas for Medical SciencesArkansas Children’s Hospital1 Children’s Way, Slot 512-5Little RockAR72202

Abstract

Objective

To compare third grade literacy and mathematics test proficiency among children born with gastroschisis vs unaffected controls and identify predictors of academic proficiency among these children.

Study design

Infants born with gastroschisis (2000-2005) were identified from the Arkansas Reproductive Health Monitoring System. For each case, 2 controls were selected at random from birth certificates and matched for hospital and month of birth, sex, and race/ethnicity. Data on rehospitalization within the first 6 years and payer data were abstracted from the Arkansas Hospital Inpatient Discharge database. Surviving cases and controls were linked to the Arkansas Department of Education database containing achievement test scores. The primary outcome was proficiency, defined as performance at or above grade level, on third grade achievement tests. Cases and controls who did not attend public schools could not be linked to education records. Multivariable logistic regression models evaluated the association between study characteristics and academic proficiency.

Results

The final study cohort included 47 cases and 63 controls. There was no statistically significant difference in the rate of literacy (68% vs 81%; P = .65) or mathematics proficiency (89% vs 87%; P = .15) between cases and controls. On multivariable analysis, a complex gastroschisis (defined as atresia, volvulus, necrosis, or perforation of the bowel) was associated with lower proficiency in literacy (aOR, 0.1; 95% CI, 0.02-0.58; P = .01). No neonatal or maternal characteristics predictive of lower proficiency in mathematics were identified.

Conclusions

Among children born with gastroschisis, the presence of a complex gastroschisis was associated with lower proficiency on third grade literacy achievement tests.

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Keywords : gastroschisis, education, readmission, outcome

Abbreviations : ACH, ADE, ADH, AHIDD, ARHMS, SGA


Plan


 Supported by the Centers for Disease Control and Prevention (Grant 1U38OT000199, to J.R.). The authors declare no conflicts of interest.
 The preliminary findings of this study were accepted for virtual poster presentation at the Society for Pediatric Research, May 2020.


© 2021  Elsevier Inc. Tous droits réservés.
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Vol 240

P. 110 - janvier 2022 Retour au numéro
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