Prevalence of mental health problems, associated factors, and health-related quality of life in children with long-gap esophageal atresia in Sweden

• Published in: Journal of pediatric surgery Vol. 58; no. 9; pp. 1646 - 1655
• Main Authors: Dellenmark-Blom, Michaela, Ax, Sofie Örnö, Lilja, Helene Engstrand, Reilly, Colin, Svensson, Jan F., Kassa, Ann-Marie, Jönsson, Linus, Abrahamsson, Kate, Gatzinsky, Vladimir, Omling, Erik, Tollne, AnnaMaria, Stenström, Pernilla, Öst, Elin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2023
• Subjects: Clinical Medicine; Congenital malformation; Esophageal atresia; Health-related quality of life; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Mental health; Pediatric surgery; Pediatrics; Pediatrik; Rare disease; Health-related quality of life; ADHD; SDQ; Pediatric surgery; Congenital malformation; Mental health; GERD; LGEA; TEF; Rare disease; Esophageal atresia; HRQOL; EA
• ISSN: 0022-3468; 1531-5037; 1531-5037
• DOI: 10.1016/j.jpedsurg.2022.12.004

Children with long-gap esophageal atresia (LGEA) face a high risk of digestive and respiratory morbidity, but their mental health outcomes have not been investigated. We aimed to identify the prevalence of mental health problems in children with LGEA, associated factors and health-related quality of life (HRQOL). Twenty-six children with LGEA aged 3–17 were recruited nationwide in Sweden. One of their parents and adolescents aged 11–17 completed information on the child's mental health (Strength and Difficulties Questionnaire), generic (PedsQL 4.0) and condition-specific HRQOL (EA-QOL). Parents gave information on current child symptomatology. Mental health level was determined using validated norms; abnormal≥90 percentile/borderline≥80 percentile/normal. Elevated levels were considered borderline/abnormal. Data were analyzed using descriptives, correlation and Mann-Whitney-U test. Significance level was p < 0.05. Twelve children with LGEA aged 3–17 (46%) had elevated scores of ≥1 mental health domain in parent-reports, whereas 2 adolescents (15%) in self-reports. In parent-reports, 31% of the children had elevated levels of peer relationship problems, with associated factors being child sex male (p = 0.037), airway infections (p = 0.002) and disturbed night sleep (p = 0.025). Similarly, 31% showed elevated levels of hyperactivity/inattention, and associated factors were male sex (p = 0.005), asthma (p = 0.028) and disturbed night sleep (p = 0.036). Elevated levels of emotional symptoms, seen in 20%, were related to swallowing difficulties (p = 0.038) and vomiting problems (p = 0.045). Mental health problems correlated negatively with many HRQOL domains (p < 0.05). Children with LGEA risk mental health difficulties according to parent-reports, especially peer relationship problems and hyperactivity/inattention, with main risk factors being male sex, airway problems and sleep disturbances. This should be considered in follow-up care and research, particularly since their mental health problems may impair HRQOL. Prognosis study, LEVEL II. •What is currently known about this topic?•Children with long-gap esophageal atresia (LGEA) face a high risk of digestive morbidity, malnutrition and lung impairments.•What new information is contained in this article?•Children with LGEA-especially boys, those with airway problems and sleep disturbances-risk mental health problems.•Their mental health difficulties may impair health-related quality of life.