Communication Affichée: Best of poster

Le 15/10/2021 de 09:00 à 10:30

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Prévalence et facteurs de risque d'anomalies de la posture sagittale chez les enfants nés avec une atrésie de l'œsophage: une étude de cohorte prospective

Benoit Bisson (Lille, France), André THEVENON (Lille, France), Frédéric GOTTRAND (Lille, France), Laurence GOTTRAND (Villeneuve-d'Ascq, France)

Objectif : Scoliosis is a well-described complication of esophageal atresia (EA) caused by the associated spine malformations and/or thoracotomy. However, the sagittal posture abnormalities in patients with EA have not been described. The aim of this study was to evaluate the prevalence of and risk factors for sagittal posture abnormalities at the age of 6 years in patients operated on for EA.

Matériel/Patients et méthodes : A prospective cohort of 123 patients with EA was examined by the same rehabilitation doctor at the time of a multidisciplinary visit scheduled at the age of 6 years. Children presenting with scoliosis (n = 4) or who missed the consultation (n = 33) were excluded. Univariate and multivariate logistic regression models with Firth’s penalized-likelihood approach were used to identify risk factors associated with sagittal posture anomalies. Candidate risk factors included neonatal characteristics, associated malformations, atresia type, postoperative complications, psychomotor development retardation, orthopedic abnormalities, and neurological hypotonia.

Résultats : The prevalence rates of sagittal posture abnormalities were 25.6% (n = 22; 95% CI, 16.7 to 36.1%). Multivariate analysis showed that minor orthopedic abnormalities (OR: 4.02, 95% CI: 1.29 to 13.43, P = 0.021), and VACTERL (OR: 3.35, 95% CI: 1.09 to 10.71, P = 0.042) were significant risk factors for sagittal posture abnormalities.

Discussion - Conclusion : This study shows that sagittal posture anomalies occur frequently in children operated on at birth for EA and are not directly linked to the surgical repair. These children should be screened and treated using postural physiotherapy, especially those with VACTERL and minor orthopedic abnormalities.

Mots clés : Esophageal atresia, sagittal posture abnormalities, VACTERL

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