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 Timely recognition and intervention are crucial for idiopathic clubfoot management, yet its developmental impact on children is 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 unexposed 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 unexposed children. Children with clubfoot had a higher rate of premature birth (7.44% vs. 3.66%, p < 0.0001), lower birth weight (3.08 ± 0.59 kg vs. 3.20 ± 0.46 kg, p < 0.0001), and higher frequency of breastfeeding (42.9% vs. 33.7%, p < 0.001), compared to the unexposed 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 clubfoot exhibited differences in neurodevelopment and height. Early parental concern and proactive therapeutic interventions are crucial during the initial stages of developmental delay in children with clubfoot.