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A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Early neurodevelopmental outcomes of infants with intestinal failure
Stephanie So1, Catherine Patterson1, Anna Gold2
1Department of Rehabilitation Services, The Hospital for Sick Children, Toronto, Ontario, Canada; Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Children with intestinal failure often experience developmental delays. Prematurity, low birth weight, and medical complications are linked to poorer neurodevelopmental outcomes, emphasizing the need for early intervention.
Area of Science:
- Pediatric Gastroenterology
- Neurodevelopmental Pediatrics
- Neonatology
Background:
- Increasing survival rates in infants and children with intestinal failure necessitate a focus on their developmental trajectory.
- Early developmental assessment is crucial for this growing population.
Purpose of the Study:
- To evaluate neurodevelopmental outcomes in children with intestinal failure up to 15 months corrected age.
- To identify clinical factors associated with developmental delays in this cohort.
Main Methods:
- Retrospective analysis of 33 children in an intestinal rehabilitation program (2011-2014).
- Utilized standardized assessments: General Movements, Movement Assessment of Infants, Alberta Infant Motor Scale, and Mullen Scales of Early Learning.
- Correlated clinical factors with developmental outcomes at 12-15 months corrected age.
Main Results:
- 88% of infants exhibited abnormal General Movements; over half had abnormal scores on motor assessments.
- Delays were observed across all Mullen Scales, particularly in gross motor skills.
- Poorer outcomes at 12-15 months were associated with prematurity, low birth weight, CNS comorbidity, prolonged NICU stay, necrotizing enterocolitis, surgeries, and conjugated hyperbilirubinemia.
Conclusions:
- Multiple risk factors contribute to early developmental delay in children with intestinal failure.
- Close developmental follow-up is essential for early identification and intervention.
Background:
The survival rate of infants and children with intestinal failure is increasing, necessitating a greater focus on their developmental trajectory.
Aims:
To evaluate neurodevelopmental outcomes in children with intestinal failure at 0-15months corrected age.
Study Design:
Analysis of clinical, demographic and developmental assessment results of 33 children followed in an intestinal rehabilitation program between 2011 and 2014. Outcome measures included: Prechtl's Assessment of General Movements, Movement Assessment of Infants, Alberta Infant Motor Scale and Mullen Scales of Early Learning. Clinical factors were correlated with poorer developmental outcomes at 12-15months corrected age.
Results:
Thirty-three infants (17 males), median gestational age 34weeks (interquartile range 29.5-36.0) with birth weight 1.98kg (interquartile range 1.17-2.50). Twenty-nine (88%) infants had abnormal General Movements. More than half had suspect or abnormal scores on the Alberta Infant Motor Scale and medium to high-risk scores for future neuromotor delay on the Movement Assessment of Infants. Delays were seen across all Mullen subscales, most notably in gross motor skills. Factors significantly associated with poorer outcomes at 12-15months included: prematurity, low birth weight, central nervous system co-morbidity, longer neonatal intensive care admission, necrotizing enterocolitis diagnosis, number of operations and conjugated hyperbilirubinemia.
Conclusion:
Multiple risk factors contribute to early developmental delay in children with intestinal failure, highlighting the importance of close developmental follow-up.
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