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Clinical predictors and prevalence of receiving special preschool/school support in children with repaired esophageal atresia

Journal article
Authors Michaela Dellenmark-Blom
L. Jonsson
V. Gatzinsky
Kate Abrahamsson
Published in Journal of Pediatric Surgery
Volume 53
Issue 10
Pages 1970-1975
ISSN 0022-3468
Publication year 2018
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 1970-1975
Language en
Keywords Esophageal atresia, Tracheoesophageal fistula, Psychosocial functioning, School support, Educational, quality-of-life, tracheoesophageal fistula, adolescents born, follow-up, morbidity, surgery, health
Subject categories Pediatric surgery


Background/purpose: In a sparsely investigated field, we aimed to evaluate the use of special preschool/school support among children with repaired esophageal atresia (EA) and/or tracheoesophageal fistula (TEF), the predicting clinical factors for this support, and level of school absence. Methods: Data on 119 EA/TEF children 2-17 years old were collected through medical records and questionnaires (response rate 95%). Logistical regression analysis identified clinical predictors of special preschool/school support in the population without genetic disorders (n = 105). Nominal hypothesis testing was performed using Fisher's exact test (p < 0.05). Results: Of the 119 children, 35.3% received special preschool/school support; 26.8% educational support, 21.8% support with nutritional intake issues and 13.4% received both types of support. Educational support was independently predicted by birthweight < 2500 g (p = 0.026) and associated anomalies (p = 0.049), nutritional intake support by gastrostomy insertion (p = 0.0028), and both types of supports by major revisional surgery (p = 0.0081). School absence >= 1 month/year, present in 25.5% of the children, was more frequently reported in children receiving preschool/school support, in preschoolers and in those with persistent respiratory problems (p < 0.05). Conclusions: Special preschool/school support is provided for approximately one-third of EA/TEF children. In EA/TEF children without genetic disorders, use of this support is predicted by congenital and surgical factors, and related to frequent school absence. (C) 2017 Elsevier Inc. All rights reserved.

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