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Neurodevelopmental Outcome of Extremely Low Birth Weight Infants with Cholestasis at 12 and 24 Months
Margarita Thanhaeuser1, David Steyrl2, Renate Fuiko1
1Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care Medicine and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
Insights
Extremely low birth weight infants with parenteral nutrition-associated cholestasis (PNAC) show delayed neurodevelopment. PNAC is linked to adverse motor outcomes in these vulnerable infants.
Area of Science:
- Neonatology
- Pediatric Neurology
- Clinical Nutrition
Background:
- Parenteral nutrition-associated cholestasis (PNAC) is a complication in extremely low birth weight (ELBW) infants.
- The neurodevelopmental impact of PNAC in ELBW infants requires further elucidation.
Purpose of the Study:
- To describe the neurodevelopmental outcomes of ELBW infants diagnosed with PNAC.
- To determine if PNAC is associated with adverse neurodevelopmental sequelae.
Main Methods:
- Secondary analysis of a controlled trial comparing lipid emulsions in ELBW infants (June 2012-October 2017).
- Neurodevelopmental follow-up at 12- and 24-month corrected ages using Bayley-III scales.
- Machine learning-based regression analysis to assess PNAC's association with neurodevelopmental outcomes.
Main Results:
- ELBW infants with PNAC exhibited globally delayed neurodevelopment at 12 and 24 months corrected age.
- Significantly lower cognitive, language, and motor scores were observed in infants with PNAC.
- Regression analyses confirmed PNAC is associated with adverse motor outcomes.
Conclusions:
- ELBW infants experiencing PNAC face an elevated risk of adverse neurodevelopmental outcomes.
- Early identification and management of PNAC may be crucial for improving long-term neurodevelopmental trajectories in ELBW infants.
Introduction:
The aims of the study were to describe the neurodevelopmental outcome of extremely low birth weight (ELBW) infants with parenteral nutrition-associated cholestasis (PNAC) and to assess whether PNAC is associated with adverse neurodevelopmental outcome.
Methods:
The study is a secondary analysis of controlled trial (June 2012-October 2017) on PNAC incidence in ELBW infants receiving two different parenteral lipid emulsions (mixed lipid emulsion containing fish oil vs. soybean oil-based). Neurodevelopmental follow-up at 12- and 24-month corrected age was compared in infants with and without PNAC. A machine learning-based regression analysis was used to assess whether PNAC was associated with adverse neurodevelopmental outcome.
Results:
For assessment of neurodevelopmental outcome (Bayley-III), 174 infants were available at 12-month (PNAC: n = 21; no PNAC: n = 153) and 164 infants at 24-month (PNAC: n = 20; no PNAC: n = 144) corrected age. The neurodevelopment of ELBW infants with PNAC was globally delayed, with significantly lower cognitive, language, and motor scores at both 12- and 24-month corrected age. Regression analyses revealed that PNAC was associated with an adverse motor outcome.
Conclusion:
ELBW infants with PNAC are at increased risk for adverse neurodevelopmental outcome.
