Lately, there have been a lot of articles on neurocognitive function. The latest (A Gold et al. JPGN 2020; 70: 225-31) describes the myriad of problems facing children with intestinal failure (IF). The authors literally used 12 different measures of neurocognitive and academic measures –though not all 28 subjects had each of these measures (Table 2).
- The authors specifically excluded 5 children with severe neurodevelopmental problems that precluded participation in standardized assessment and 10 children who were transplant recipients.
- Also, when judging the results, it is important to keep in mind that their cohort had a good maternal education level; 68% were college graduates.
- 13 of 28 (46%) received a diagnosis of cognitive/learning DSM diagnosis
- 29% met diagnostic criteria for a learning disability, 7% for ADHD, and 11% for intellectual disability; comparison Canadian prevalence rates are 4%, 5%, and 1% respectively
- The number of first-year septic episodes was associated with poorer outcomes; ≥2 or more episodes increased the likelihood.
- Sustained cholestasis was associated with poor outcomes
- The average level of intellectual functioning in their sample of 28 children was within 1 standard deviation of the population mean
There are a lot of risk factors for neurodevelopment impairment in these children with IF: prematurity, nutritional status/specific nutrient deficiencies, cholestasis, need for anesthesia/surgeries
My take: More than half of children with IF had neurodevelopemental impairment. In this cohort, recurrent sepsis in the first year of life and sustained cholestasis were associated risk factors.
Related blog posts:
- Neonatal Nutrition Lecture -What We Know Right Now …
- Improving Outlook in Neonatal Nutrition (Part 1)
- Nutrition Week (Day 2) SMOFlipid
- #NASPGHAN19 Intestinal Failure Session (Part 1)
- #NASPGHAN19 Intestinal Failure Session (Part 2)
- #NASPGHAN17 Intestinal Failure (& Other) Presentations