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Prematurity and biliary atresia: a 30-year observational study
Natalie Durkin1, Maesha Deheragoda2, Mark Davenport3
1Department of Paediatric Surgery, King's College Hospital, London, SE5 9RS, UK.
Pediatric Surgery International
|October 15, 2017
Summary
Premature infants with biliary atresia (BA) experience similar outcomes to term infants, despite delayed diagnosis. This study suggests prematurity does not negatively impact BA prognosis, challenging previous assumptions.
Area of Science:
- Pediatric Surgery
- Neonatology
- Gastroenterology
Background:
- Biliary atresia (BA) diagnosis is challenging, with timely surgery crucial for outcomes.
- Prematurity may complicate BA diagnosis and affect surgical timing.
- Understanding outcomes in premature BA infants is essential for optimizing care.
Purpose of the Study:
- To assess if premature BA infants (PBA) experience delayed surgery.
- To determine if prematurity is associated with worse outcomes in BA.
- To compare surgical timing and outcomes between PBA and term BA infants.
Main Methods:
- Retrospective matched cohort study comparing PBA with term BA controls.
- Prematurity defined as delivery < 37 weeks gestation.
- Primary outcomes: jaundice clearance and native liver survival; secondary: fibrosis assessment.
Main Results:
- PBA infants had higher rates of twin pregnancy and syndromic BA.
- Delayed diagnosis (>50 days) was observed in 13 PBA infants.
- No significant differences in jaundice clearance, native liver survival, or overall survival were found between groups.
Conclusions:
- Premature BA infants demonstrate comparable outcomes to term infants.
- Despite delayed diagnosis, prematurity does not appear to worsen BA prognosis.
- High incidence of discordant twins suggests potential epigenetic factors in BA pathogenesis.