Neurodevelopmental outcomes of children with gastroschisis at university hospital in northeast Thailand

Background: Gastroschisis is common among congenital abdominal wall defects. The cause is unknown but it was found to be associated with young maternal age. The association between gastroschisis and delayed development is undetermined. Objective: We described neurodevelopmental outcomes in patients with gastroschisis at 24 +/- 6 months corrected age (CA) and identify factors associated with delayed neurodevelopmental outcomes. Method: This is a cross sectional descriptive study, in patients with gastroschisis born between July 2007 and December 2008, who were admitted to the neonatal unit at Srinagarind hospital, a university hospital in northeast Thailand. The patients underwent developmental assessment at 24 +/- 6 months CA by Bayley Scales of Infant Development III (BSID III) which assesses three domains: cognitive, language and motor development. Result: Fifteen of 21 patients with gastroschisis were included in the study. The mean age at follow up was 21.8 +/- 3.9 months. Four patients (26.7%) had delayed development. One was mildly delayed in all aspects including cognitive, language, and motor development. Three patients (20%) had mild delay in language development only. No significant risk factor associated with delayed neurodevelopmental outcomes was identified. Transient hypothyroidism from iodine excess was found in three out of four patients (75%) who had undergone the silo-operation (p=0.01). Conclusion: Developmental evaluation should be performed in patients with gastroschisis because we found that 26.7% of patients with gastroschisis had delayed development. However, significant risk factors could not be identified due to limited number of subjects. If the patient underwent the silo-operation, thyroid function should be tested and closely followed-up.