Motor-function and exercise capacity in children with major anatomical congenital anomalies: An evaluation at 5 years of age

Background: Children with major anatomical congenital anomalies (CA) often need prolonged hospitalization with surgical interventions in the neonatal period and thereafter. Better intensive care treatment has reduced mortality rates, but at the cost of more morbidity. Aim: To study motor-function and exercise capacity in five-year-old children born with CA, and to determine whether motor-function and exercise capacity differ according to primary diagnosis. Study design: Descriptive study. Subjects: One-hundred-and-two children with the following CA: congenital diaphragmatic hernia (CDH) n = 24, esophageal atresia (EA) n = 29, small intestinal anomalies (SIA) n = 25, and abdominal wall defects (AWD) n = 24. Outcome measures: Overall and subtest percentile scores of the Movement-Assessment Battery for Children (M-ABC) were used to measure motor skills. Endurance time on the Bruce treadmill test was used to determine maximal exercise capacity. Results: Motor-function: Seventy-three children (71.6%) had an overall percentile score within the normal range, 18 (17.6%) were classified as borderline, and 11(10.8%) had a motor problem. This distribution was different from that in the reference population (Chi square: p = 0.001). Most problems were encountered in children with CDH and EA (p = 0.001 and 0.013, respectively). Ball skills and balance were most affected. Exercise capacity: Mean standard deviation score (SDS) endurance time = -0.5 (SD: 1.3); p = 0.001; due to poor exercise performance in CDH and EA patients. Conclusions: Children with major anatomical CA and especially those with CDH and EA are at risk for delayed motor-function and disturbed exercise capacity. (C) 2010 Elsevier Ireland Ltd. All rights reserved.