Risk factors for short- and long-term morbidity in children with esophageal atresia

J Pediatr. 2010 May;156(5):755-60. doi: 10.1016/j.jpeds.2009.11.038. Epub 2010 Jan 31.


Objective: To describe short- (first year of age) and long-term (after 1 year of age) outcome in patients with esophageal atresia and identify early predictive factors of morbidity in the first month of life.

Study design: Charts of children with esophageal atresia born January 1990 to May 2005 were reviewed. A complicated evolution was defined as the occurrence of at least 1 complication: severe gastroesophageal reflux, esophageal stricture requiring dilatations, recurrent fistula needing surgery, need for gavage feeding for >or=3 months, severe tracheomalacia, chronic respiratory disease, and death.

Results: A total of 134 patients were included. Forty-nine percent of patients had a complicated evolution before 1 year of age, and 54% had a complicated evolution after 1 year. With bivariate analysis, predictive variables of a complicated evolution were demonstrated, including twin birth, preoperative tracheal intubation, birth weight <2500 g, long gap atresia, anastomotic leak, postoperative tracheal intubation >or=5 days, and inability to be fed orally by the end of the first month. After 1 year of age, the complicated evolution was only associated with long gap atresia and inability to be fed orally in the first month. A hospital stay >or=30 days was associated with a risk of a complicated evolution at 1 year and after 1 year of age (odds ratio, 9.3 [95% CI, 4.1-20.8] and 3.5 [95% CI, 1.6-7.6], respectively).

Conclusion: Early factors are predictive of morbidity in children with esophageal atresia.

MeSH terms

  • Esophageal Atresia / complications*
  • Esophageal Atresia / surgery
  • Esophageal Stenosis / etiology
  • Female
  • Gastroesophageal Reflux / etiology
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Photosensitivity Disorders
  • Recurrence
  • Respiratory Tract Diseases / etiology
  • Risk Factors
  • Tracheoesophageal Fistula / complications
  • Tracheoesophageal Fistula / surgery
  • Tracheomalacia / etiology