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Oral Presentation - 37
Prevalence and predictors of mental health difficulties in adolescents born with esophageal atresia in conjunction with transfer from pediatric to adult care - a nationwide prospective observational study in Sweden
M Dellenmark-Blom*, E Gustafsson**, E Omling***, C Reilly****, H Engstrand Lilja*****, J F Svensson******, S Persson*******, L Jönsson*******, V Gatzinsky*******, N Högberg**, K Abrahamsson*******, T Wester******, E Öst******
*Department of Pediatric Surgery, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden Institute of Clinical Sciences, Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden
**Department of Pediatric Surgery, University Children's Hospital, Uppsala, Sweden Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
***Department of Pediatric surgery, Skane University Hospital, Lund University, Lund, Sweden
****Institute of Clinical Sciences, Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden
*****Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
******Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden
*******Department of Pediatric Surgery, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden Institute of Clinical Sciences, Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden
Purpose:To identify the prevalence and predictors of mental health difficulties (MHD) in adolescents with esophageal atresia (EA) in conjunction with transfer from pediatric to adult care.
Method:An ongoing prospective study including all four teaching hospitals in Sweden providing follow-up care to adolescents with EA aged 15-16, i.e. prior to transfer to adult care, was established (Ethical approval 2021-04051). Over 3-years, these adolescents and one of their parents completed a validated screening instrument for MHD (Strength and Difficulties Questionnaire, SDQ). Mental health status was determined using validated norms; abnormal (90thpercentile), borderline (80thpercentile), normal. Higher scores indicate more MHD. Elevated levels were considered borderline/abnormal. Clinical data was collected via medical records. Data was analyzed using descriptive statistics and linear regression. Significance level was p<0.05.
Results:Ninety-two participants; 46 dyads of adolescents with EA and their parents completed SDQ. Elevated levels of MHD in self-/parent-reports were: peer relationship problems 33%/18%; hyperactivity/inattention 9%/16%; emotional symptoms 13%/13%; conduct problems 4%/9%; total difficulties 7%/9%. The peer problems scores increased with associated anomalies (self-report, p=0.027; parent-report, p=0.046) and “Apparent Life-Threatening Events” ≤1year of age (self-report, p=0.042). The hyperactivity/inattention scores decreased with a primary anastomosis (parent-report, p=0.003) and increased with a gastrostomy at 1 year of age (parent-report, p=0.006). The total difficulties scores increased with associated anomalies (self-report, p=0.046) and VACTERL association (self-report, p=0.024), but decreased with higher gestational age at birth (parent-report, p=0.033).
Conclusion:Our preliminary results suggest a subgroup of adolescents with EA has MHD, most commonly peer problems. Adolescents born preterm, with associated anomalies and with gastrostomy at one year of age are at higher risk. This information can help optimize transition from pediatric to adult care.