RESUMEN
AIM OF THE STUDY: Esophageal atresia (EA) is associated with impaired motor development, cardiopulmonary function and physical activity (PA). Despite missing scientific evidence, this fact is often attributed to associated congenital heart disease (CHD). The aim of this study is to investigate PA in EA patients without CHD compared to CHD patients and healthy controls. METHODS: In this multicenter study, EA patients aged 6 through 17 years were included. Moderate-to-vigorous physical activity (MVPA, minutes per week) was assessed using the standardized and validated questionnaire MoMo-PAQ. EA patients were randomly matched 1:4 for gender and age with patients with CHD (n=1262) and healthy controls (n=6233). Patients born with both EA and CHD were excluded. Means and 95%-confidence intervals (95%-CI) were calculated. To identify associated factors, Spearman correlation was performed. MAIN RESULTS: Overall, 69 EA patients were matched with 276 CHD patients and 276 controls (57% male, 43% female, mean age 10,3 years, 95%-CI: 9,5-11,1). Mean MVPA was reduced in EA (492 minutes, 95%-CI: 387-598) and CHD patients (463 minutes, 95%-CI: 416-511) compared to controls (613 minutes, 95%-CI: 548-679). In subgroup analysis, MVPA was reduced further in females and older age groups with EA and CHD. For EA patients, there was no statistical association between Gross type, current symptoms, surgical approaches and MVPA. CONCLUSIONS: Isolated EA and CHD were associated with reduced PA, especially in females and teenagers. To avoid additional morbidity associated with sedentary behaviour, PA should be promoted during follow-up.
RESUMEN
BACKGROUND: Esophageal atresia (EA) is a rare malformation with a wide range of co-morbidity and associated malformations impairing weight gain and growth. The aim of this study was to calculate specific percentiles for body weight and height for children born with esophageal atresia according to sex from birth to the age of 6 years, accounting for prematurity and presence of congenital heart disease (CHD). METHODS: Data was extracted from an anonymized voluntary national registry for patients born with esophageal atresia between 2001 and 2021, from birth until the age of six years. Missing values were imputed using a multiple imputation approach. In premature infants, chronological age was corrected for gestational week until the age of one year. The impact of sex and additional congenital heart disease on weight gain and growth was analysed using quartile regression models. RESULTS: In total, 1812 examinations of 485 patients were considered and 1232 examinations of 301 patients were finally included. Most data was available for children at birth and during the first year of life. Body weight was imputed for 3.3% and height for 12.5% of examinations. The mean body weight-for-age and length-for-age at birth according to gestational age was lower in EA patients and median body weight developed along the tenth percentile compared to the general population. Median height-for-age was at the 50th percentile during the first months of life, before crossing to lower percentiles before the age of one year. CHD had an additional negative impact on growth and weight gain, especially during the first year of life. CONCLUSIONS: Children with EA had a reduced bodyweight and -height compared to the general population. Therefore, specific percentile curves are helpful to evaluate growth and development. Especially during the first year of life, particular attention is necessary and complications leading to a reduced calorie intake should be treated without delay to promote timely development and growth. Cardiac co-morbidities may further compromise weight gain in these patients, implying that such patients should be under even closer surveillance.