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Is neurodevelopment impaired in Brazilian children with intestinal failure on prolonged parenteral nutrition? A
Cristina Miller1, Renata R Kieling2, Bruna Ziegler3
1Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. cmiller@hcpa.edu.br.
Insights
Young children with intestinal failure (IF) on prolonged parenteral nutrition (PN) often experience neurodevelopmental delays. Approximately one-third showed impairments in cognitive, motor, and language skills, highlighting the need for early intervention.
Area of Science:
- Pediatric Gastroenterology
- Neurodevelopmental Pediatrics
- Parenteral Nutrition
Background:
- Intestinal failure (IF) in young children necessitates prolonged parenteral nutrition (PN).
- Neurodevelopmental outcomes in this vulnerable population require thorough assessment.
- The impact of IF and PN on cognitive, motor, and language development is a critical concern.
Purpose of the Study:
- To evaluate the neurodevelopmental outcomes of children under 42 months with IF receiving prolonged PN.
- To assess the effectiveness of a Pediatric Multidisciplinary Intestinal Rehabilitation Program.
- To identify potential associations between clinical variables and neurodevelopmental status.
Main Methods:
- The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III) was used for assessment.
- Children aged 2-42 months with IF on PN for >60 days were included.
- Developmental delay was defined as scores 2 standard deviations below the mean in cognitive, motor, or language domains.
Main Results:
- Developmental delay was observed in 34% (cognitive), 33% (motor), and 27% (language) of the 24 studied children.
- The median age of participants was 17.5 months.
- No significant associations were found between Bayley III scores and hospitalization duration, prematurity, or number of surgeries.
Conclusions:
- A significant proportion of young children with IF on prolonged PN exhibit neurodevelopmental impairments.
- These deficits span cognitive, motor, and language domains.
- Early and comprehensive multidisciplinary interventions are crucial for managing IF and supporting neurodevelopment.
Purpose:
To assess the neurodevelopment outcomes of children younger than 42 months of age with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by a Pediatric Multidisciplinary Intestinal Rehabilitation Program from a public tertiary hospital in Brazil.
Methods:
Bayley III scale was administered in children aged 2 to 42 months with IF and receiving PN for more than 60 days. Composite scores in cognitive, motor, and language domains were analyzed. Developmental delay was defined as a performance 2 standard deviations (SD) below the average at the 3 domains. Association between Bayley III composite scores and clinical variables related to IF were tested.
Results:
Twenty-four children with median (IQR) age of 17.5 months (9-28.5) were studied, 58.3% were male. Developmental delay was found in 34%, 33% and 27% of the patients in cognitive, motor, and language domains, respectively. There was no significant association between the Bayley-III composite scores and length of hospitalization, prematurity, and number of surgical procedures with anesthesia.
Conclusion:
The study demonstrated impairments in the cognitive, motor and language domains in approximately one-third of young patients with IF on prolonged PN.
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