Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study

Abstract Study design Population-based retrospective cohort study. Objectives The developmental impact of idiopathic clubfoot on children remains underexplored. This study investigates neurodevelopment and physical growth in children with idiopathic clubfoot up to age six. Methods This population-ba...

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Main Authors: Sung Tan Cho, Ha-Na Yoo, Simho Jeong, Ju Hee Kim, Eun Kyo Ha, Bo Eun Han, Wongthawat Liawrungrueang, Man Yong Han, Soonchul Lee
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08810-w
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author Sung Tan Cho
Ha-Na Yoo
Simho Jeong
Ju Hee Kim
Eun Kyo Ha
Bo Eun Han
Wongthawat Liawrungrueang
Man Yong Han
Soonchul Lee
author_facet Sung Tan Cho
Ha-Na Yoo
Simho Jeong
Ju Hee Kim
Eun Kyo Ha
Bo Eun Han
Wongthawat Liawrungrueang
Man Yong Han
Soonchul Lee
author_sort Sung Tan Cho
collection DOAJ
description Abstract Study design Population-based retrospective cohort study. Objectives The developmental impact of idiopathic clubfoot on children remains underexplored. This study investigates neurodevelopment and physical growth in children with idiopathic clubfoot up to age six. Methods This population-based retrospective cohort study was conducted in South Korea (2009–2019) using linked data from National Health Insurance Service. The cohort included children diagnosed with idiopathic clubfoot and 1:10 exact match of healthy control children. Neurodevelopmental assessments were conducted using the validated Korean Developmental Screening Test, which covers six domains: gross motor skills, fine motor skills, cognition, language, social skills, and self-regulation, for children aged 42–71 months. Secondary outcomes measured were height and body mass index (BMI) Z-score during the same period. Results The cohort comprised 484 children with idiopathic clubfoot and 4,840 matched healthy control children. Children with clubfoot had a higher rate of premature birth (7.44% vs. 3.66%, p < 0.0001) and lower birth weight (3.08 ± 0.59 kg vs. 3.20 ± 0.46 kg, p < 0.0001) compared to the healthy control children. In-depth evaluation of all six neurodevelopmental domains showed significant differences in children with clubfoot (overall aOR, 3.671; 95% CI, 2.463–5.471). Children with clubfoot showed a significant height delay (Z score, -1.63 below), but no BMI difference was noted. Conclusions Children with idiopathic clubfoot demonstrated increased risk of neurodevelopmental delays and reduced height compared to their peers. These findings underscore the importance of early recognition and ongoing monitoring by parents and pediatricians.
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spelling doaj-art-1ae5a5c79dd2485da6892a4e1b4f72a02025-08-20T02:05:44ZengBMCBMC Musculoskeletal Disorders1471-24742025-06-0126111110.1186/s12891-025-08810-wTracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort studySung Tan Cho0Ha-Na Yoo1Simho Jeong2Ju Hee Kim3Eun Kyo Ha4Bo Eun Han5Wongthawat Liawrungrueang6Man Yong Han7Soonchul Lee8Department of Orthopaedic Surgery, Seoul Seonam HospitalDepartment of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of MedicineDepartment of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of MedicineDepartment of Pediatrics, Kyung Hee University Medical CenterDepartment of Pediatrics, Hallym University Kangnam Sacred Heart HospitalDepartment of Pediatrics, CHA Bundang Medical Center, CHA University School of MedicineDepartment of Orthopaedic Surgery, School of Medicine, University of PhayaoDepartment of Pediatrics, CHA Bundang Medical Center, CHA University School of MedicineDepartment of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of MedicineAbstract Study design Population-based retrospective cohort study. Objectives The developmental impact of idiopathic clubfoot on children remains underexplored. This study investigates neurodevelopment and physical growth in children with idiopathic clubfoot up to age six. Methods This population-based retrospective cohort study was conducted in South Korea (2009–2019) using linked data from National Health Insurance Service. The cohort included children diagnosed with idiopathic clubfoot and 1:10 exact match of healthy control children. Neurodevelopmental assessments were conducted using the validated Korean Developmental Screening Test, which covers six domains: gross motor skills, fine motor skills, cognition, language, social skills, and self-regulation, for children aged 42–71 months. Secondary outcomes measured were height and body mass index (BMI) Z-score during the same period. Results The cohort comprised 484 children with idiopathic clubfoot and 4,840 matched healthy control children. Children with clubfoot had a higher rate of premature birth (7.44% vs. 3.66%, p < 0.0001) and lower birth weight (3.08 ± 0.59 kg vs. 3.20 ± 0.46 kg, p < 0.0001) compared to the healthy control children. In-depth evaluation of all six neurodevelopmental domains showed significant differences in children with clubfoot (overall aOR, 3.671; 95% CI, 2.463–5.471). Children with clubfoot showed a significant height delay (Z score, -1.63 below), but no BMI difference was noted. Conclusions Children with idiopathic clubfoot demonstrated increased risk of neurodevelopmental delays and reduced height compared to their peers. These findings underscore the importance of early recognition and ongoing monitoring by parents and pediatricians.https://doi.org/10.1186/s12891-025-08810-wIdiopathic clubfootNeurodevelopmentPhysical growthDevelopmental delayCohort study
spellingShingle Sung Tan Cho
Ha-Na Yoo
Simho Jeong
Ju Hee Kim
Eun Kyo Ha
Bo Eun Han
Wongthawat Liawrungrueang
Man Yong Han
Soonchul Lee
Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study
BMC Musculoskeletal Disorders
Idiopathic clubfoot
Neurodevelopment
Physical growth
Developmental delay
Cohort study
title Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study
title_full Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study
title_fullStr Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study
title_full_unstemmed Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study
title_short Tracing neurodevelopment and growth pattern in six-year-old children with idiopathic clubfoot: a national cohort study
title_sort tracing neurodevelopment and growth pattern in six year old children with idiopathic clubfoot a national cohort study
topic Idiopathic clubfoot
Neurodevelopment
Physical growth
Developmental delay
Cohort study
url https://doi.org/10.1186/s12891-025-08810-w
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