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Aim To compare the developmental outcome of infants with oesophageal atresia with or without trachea-oesophageal fistula ( OA/ TOF) who underwent surgery in early infancy with healthy control infants in New South Wales, Australia. Methods Infants diagnosed with OA/ TOF requiring surgical intervention were enrolled prospectively between 1 August 2006 and the 31 December 2008. Healthy control infants were enrolled in the same time period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development ( Version III). Results Of 34 infants with OA/ TOF that were enrolled, 31 had developmental assessments. The majority (75%) were term infants (≥37 weeks gestation) with a mean birth weight of 2717 g. Fourteen infants (44%) had an associated birth defect and one infant with multiple associated anomalies subsequently died. Developmental assessments were also performed on 62 control infants matched for gestational age. Infants with OA/ TOF had a mean score significantly lower on the expressive language subscale ( P < 0.05) compared with the control infants. Conclusions This study found a lower than expected developmental score for infants following surgery for OA/ TOF in the expressive language subscale compared with the healthy control infants. These findings support concerns over the potential impact of OA/ TOF and its effects on development. Further studies, including continuing developmental review to determine whether these differences persist and their functional importance, should be performed. [ABSTRACT FROM AUTHOR]