Swallowing-related quality of life in children with oesophageal atresia: a national cohort study
Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On...
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Published in | European journal of pediatrics Vol. 182; no. 1; pp. 275 - 283 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.01.2023
Springer Nature B.V |
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Abstract | Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On the other hand, primary repair may have the benefit of early commencement of oral feedings. We hypothesize that also in the medium-term, swallowing-related quality of life is better after primary oesophageal repair. We conducted a prospective cross-sectional study on swallowing quality in a national cohort of former VLBW and ELBW children with OA, using the structured paediatric swallowing quality of life (
pedSWAL-QOL
) questionnaire. Results were correlated with surgical approach and baseline clinical data. Principal component analysis of
pedSWAL-QOL
domains was performed. In total, 44 complete data sets of 78 children were available. The mean age of children was 8.5 years (SD = 7.4), and 23 children (52%) had primary OA repair. The overall median
pedSWAL-QOL
score was 2 (IQR = 0–3), representing a high swallowing-related quality of life, independent of surgical technique (
p
= 0.086). Children with a history of intracranial haemorrhage (ICH) (
p
= 0.002) and those with VACTERL association (
p
= 0.008) had significantly decreased enjoyment with eating. In addition, children with VACTERL association had problems to find suitable foods (
p
= 0.04).
Conclusion
: In this national cohort of VLBW and ELBW preterm-born children with OA, swallowing-related quality of life is good, mostly independent of initial surgery. Children with OA and ICH or VACTERL association may require more intense support with feeding.
What is Known:
• Dysphagia, resembling feeding and swallowing disorders, is common in children and adults with repaired oesophageal atresia. Nevertheless, dysphagia in children with oesophageal atresia decreases with age.
• Parents of younger children suffer from increased anxiety and fear regarding eating and swallowing abilities of their children.
What is New:
• Swallowing-related quality of life in former preterm children with oesophageal atresia is good, independent of initial surgical approach (primary vs. staged repair), even in very low birth weight or extreme low birth weight infants.
• Children suffering from VACTERL association or intracranial haemorrhage show decreased enjoyment with eating. |
---|---|
AbstractList | Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On the other hand, primary repair may have the benefit of early commencement of oral feedings. We hypothesize that also in the medium-term, swallowing-related quality of life is better after primary oesophageal repair. We conducted a prospective cross-sectional study on swallowing quality in a national cohort of former VLBW and ELBW children with OA, using the structured paediatric swallowing quality of life (
pedSWAL-QOL
) questionnaire. Results were correlated with surgical approach and baseline clinical data. Principal component analysis of
pedSWAL-QOL
domains was performed. In total, 44 complete data sets of 78 children were available. The mean age of children was 8.5 years (SD = 7.4), and 23 children (52%) had primary OA repair. The overall median
pedSWAL-QOL
score was 2 (IQR = 0–3), representing a high swallowing-related quality of life, independent of surgical technique (
p
= 0.086). Children with a history of intracranial haemorrhage (ICH) (
p
= 0.002) and those with VACTERL association (
p
= 0.008) had significantly decreased enjoyment with eating. In addition, children with VACTERL association had problems to find suitable foods (
p
= 0.04).
Conclusion
: In this national cohort of VLBW and ELBW preterm-born children with OA, swallowing-related quality of life is good, mostly independent of initial surgery. Children with OA and ICH or VACTERL association may require more intense support with feeding.
What is Known:
• Dysphagia, resembling feeding and swallowing disorders, is common in children and adults with repaired oesophageal atresia. Nevertheless, dysphagia in children with oesophageal atresia decreases with age.
• Parents of younger children suffer from increased anxiety and fear regarding eating and swallowing abilities of their children.
What is New:
• Swallowing-related quality of life in former preterm children with oesophageal atresia is good, independent of initial surgical approach (primary vs. staged repair), even in very low birth weight or extreme low birth weight infants.
• Children suffering from VACTERL association or intracranial haemorrhage show decreased enjoyment with eating. Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On the other hand, primary repair may have the benefit of early commencement of oral feedings. We hypothesize that also in the medium-term, swallowing-related quality of life is better after primary oesophageal repair. We conducted a prospective cross-sectional study on swallowing quality in a national cohort of former VLBW and ELBW children with OA, using the structured paediatric swallowing quality of life (pedSWAL-QOL) questionnaire. Results were correlated with surgical approach and baseline clinical data. Principal component analysis of pedSWAL-QOL domains was performed. In total, 44 complete data sets of 78 children were available. The mean age of children was 8.5 years (SD = 7.4), and 23 children (52%) had primary OA repair. The overall median pedSWAL-QOL score was 2 (IQR = 0-3), representing a high swallowing-related quality of life, independent of surgical technique (p = 0.086). Children with a history of intracranial haemorrhage (ICH) (p = 0.002) and those with VACTERL association (p = 0.008) had significantly decreased enjoyment with eating. In addition, children with VACTERL association had problems to find suitable foods (p = 0.04). In this national cohort of VLBW and ELBW preterm-born children with OA, swallowing-related quality of life is good, mostly independent of initial surgery. Children with OA and ICH or VACTERL association may require more intense support with feeding. • Dysphagia, resembling feeding and swallowing disorders, is common in children and adults with repaired oesophageal atresia. Nevertheless, dysphagia in children with oesophageal atresia decreases with age. • Parents of younger children suffer from increased anxiety and fear regarding eating and swallowing abilities of their children. • Swallowing-related quality of life in former preterm children with oesophageal atresia is good, independent of initial surgical approach (primary vs. staged repair), even in very low birth weight or extreme low birth weight infants. • Children suffering from VACTERL association or intracranial haemorrhage show decreased enjoyment with eating. Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On the other hand, primary repair may have the benefit of early commencement of oral feedings. We hypothesize that also in the medium-term, swallowing-related quality of life is better after primary oesophageal repair. We conducted a prospective cross-sectional study on swallowing quality in a national cohort of former VLBW and ELBW children with OA, using the structured paediatric swallowing quality of life (pedSWAL-QOL) questionnaire. Results were correlated with surgical approach and baseline clinical data. Principal component analysis of pedSWAL-QOL domains was performed. In total, 44 complete data sets of 78 children were available. The mean age of children was 8.5 years (SD = 7.4), and 23 children (52%) had primary OA repair. The overall median pedSWAL-QOL score was 2 (IQR = 0-3), representing a high swallowing-related quality of life, independent of surgical technique (p = 0.086). Children with a history of intracranial haemorrhage (ICH) (p = 0.002) and those with VACTERL association (p = 0.008) had significantly decreased enjoyment with eating. In addition, children with VACTERL association had problems to find suitable foods (p = 0.04). CONCLUSIONIn this national cohort of VLBW and ELBW preterm-born children with OA, swallowing-related quality of life is good, mostly independent of initial surgery. Children with OA and ICH or VACTERL association may require more intense support with feeding. WHAT IS KNOWN• Dysphagia, resembling feeding and swallowing disorders, is common in children and adults with repaired oesophageal atresia. Nevertheless, dysphagia in children with oesophageal atresia decreases with age. • Parents of younger children suffer from increased anxiety and fear regarding eating and swallowing abilities of their children. WHAT IS NEW• Swallowing-related quality of life in former preterm children with oesophageal atresia is good, independent of initial surgical approach (primary vs. staged repair), even in very low birth weight or extreme low birth weight infants. • Children suffering from VACTERL association or intracranial haemorrhage show decreased enjoyment with eating. Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On the other hand, primary repair may have the benefit of early commencement of oral feedings. We hypothesize that also in the medium-term, swallowing-related quality of life is better after primary oesophageal repair. We conducted a prospective cross-sectional study on swallowing quality in a national cohort of former VLBW and ELBW children with OA, using the structured paediatric swallowing quality of life (pedSWAL-QOL) questionnaire. Results were correlated with surgical approach and baseline clinical data. Principal component analysis of pedSWAL-QOL domains was performed. In total, 44 complete data sets of 78 children were available. The mean age of children was 8.5 years (SD = 7.4), and 23 children (52%) had primary OA repair. The overall median pedSWAL-QOL score was 2 (IQR = 0–3), representing a high swallowing-related quality of life, independent of surgical technique (p = 0.086). Children with a history of intracranial haemorrhage (ICH) (p = 0.002) and those with VACTERL association (p = 0.008) had significantly decreased enjoyment with eating. In addition, children with VACTERL association had problems to find suitable foods (p = 0.04). Conclusion: In this national cohort of VLBW and ELBW preterm-born children with OA, swallowing-related quality of life is good, mostly independent of initial surgery. Children with OA and ICH or VACTERL association may require more intense support with feeding. What is Known:• Dysphagia, resembling feeding and swallowing disorders, is common in children and adults with repaired oesophageal atresia. Nevertheless, dysphagia in children with oesophageal atresia decreases with age.• Parents of younger children suffer from increased anxiety and fear regarding eating and swallowing abilities of their children.What is New:• Swallowing-related quality of life in former preterm children with oesophageal atresia is good, independent of initial surgical approach (primary vs. staged repair), even in very low birth weight or extreme low birth weight infants. • Children suffering from VACTERL association or intracranial haemorrhage show decreased enjoyment with eating. |
Author | von Schweinitz, Dietrich Bergmann, Sandra Widenmann-Grolig, Anke Ritz, Laura Antonia Jechalke, Stephan Hubertus, Jochen Lurz, Eberhard |
Author_xml | – sequence: 1 givenname: Sandra surname: Bergmann fullname: Bergmann, Sandra email: sandra.bergmann@med.uni-muenchen.de organization: Department of Paediatric Surgery, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich – sequence: 2 givenname: Laura Antonia surname: Ritz fullname: Ritz, Laura Antonia organization: Sana Klinikum Lichtenberg – sequence: 3 givenname: Anke surname: Widenmann-Grolig fullname: Widenmann-Grolig, Anke organization: Patient Support Group KEKS e.V – sequence: 4 givenname: Stephan surname: Jechalke fullname: Jechalke, Stephan organization: Patient Support Group KEKS e.V – sequence: 5 givenname: Dietrich surname: von Schweinitz fullname: von Schweinitz, Dietrich organization: Department of Paediatric Surgery, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich – sequence: 6 givenname: Jochen surname: Hubertus fullname: Hubertus, Jochen organization: Department of Paediatric Surgery, Marien Hospital Witten, University Hospital of the Ruhr University Bochum – sequence: 7 givenname: Eberhard surname: Lurz fullname: Lurz, Eberhard email: eberhard.lurz@med.uni-muenchen.de organization: Department of Paediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36331620$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1002_ohn_839 crossref_primary_10_54033_cadpedv21n6_265 crossref_primary_10_1186_s13023_024_03259_x |
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Keywords | Very low birth weight (VLBW) Swallowing quality (SWAL-QoL) Oesophageal atresia (OA) Extreme low birth weight (ELBW) Oesophageal repair |
Language | English |
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SubjectTerms | Adult Birth weight Child Children Cohort analysis Cohort Studies Cross-Sectional Studies Deglutition Deglutition Disorders - etiology Dysphagia Esophageal Atresia - complications Esophageal Atresia - surgery Esophagus Hemorrhage Humans Infant Infant, Newborn Infant, Premature Infants Low birth weight Medicine Medicine & Public Health Pediatrics Principal components analysis Prospective Studies Quality of Life Swallowing |
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Title | Swallowing-related quality of life in children with oesophageal atresia: a national cohort study |
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