Physical Activity Levels in Children with Esophageal Atresia and Congenital Heart Disease: A Comparative Multicenter Study

Abstract

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.