Virtual follow-up of long-term physical, mental and educational outcomes for children with congenital diaphragmatic hernia
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Date
2020
Authors
Derraugh, Gabrielle
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Abstract
Problem
Improved survival of babies born with congenital diaphragmatic hernia (CDH) has predisposed these children to long-term morbidities. There is currently limited long-term outcome data that can be used to counsel parents and provide evidence-informed long-term care. The aim of this study was to determine if children born with CDH have different long-term physical health, mental health and educational outcomes compared to age-matched controls.
Methods
We performed a retrospective cohort study of CDH children born between 1992-2017. CDH cases were identified from Winnipeg’s Surgical Database of Outcomes and Management (WiSDOM), and a 10:1 date-of-birth matched control population was selected using the Manitoba Centre for Health Policy (MCHP) data repository. International Classification of Disease (ICD) codes, Drug Program Information Network (DPIN), special education funding, Early Development Instrument (EDI), Grade 3, 7, 8 assessments, grade 9 completion and high-school graduation were used to assess outcomes.
Results
A total of 90 CDH children and 896 controls were identified. We found that CDH children 0-5 years-of-age have a higher risk of chronic airway obstruction, pneumonia, other diseases of the lung (e.g. chronic respiratory failure), other diseases of the respiratory system (e.g. bronchospasms), chronic pulmonary heart disease, symptoms concerning nutrition and development (e.g. failure-to-thrive), diseases of the esophagus (e.g. esophageal reflux), intestinal obstruction, deformities of curvature of spine (e.g. scoliosis), developmental disorders, specific delays in development and hearing loss. CDH Children 6-12 years-of-age were found to have a higher prevalence of asthma, diseases of the esophagus and hearing loss. No difference in physical health outcomes was found for children 13-19 years-of-age. Mental health outcomes and educational outcomes were found to be similar between CDH cases and controls.
Conclusion
The results from our study suggest that children born with CDH have worse physical health outcomes compared to age-matched controls, primarily in the first five years-of-life. No difference was found for mental health or educational outcomes in the first 19 years-of-life.
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Keywords
Congenital diaphragmatic hernia, Long-term outcomes, Physical health outcome, Mental health outcome, Educational outcome