In:
Journal of Pediatric Gastroenterology & Nutrition, Ovid Technologies (Wolters Kluwer Health), Vol. 70, No. 1 ( 2020-01), p. 79-86
Abstract:
The aim of the study was to assess neurodevelopmental outcomes among children with biliary atresia (BA) surviving with their native liver at ages 3 to 12 years and evaluate variables that associate with neurodevelopment. Methods: Participants (ages 3–12 years) in a prospective, longitudinal, multicenter study underwent neurodevelopmental testing with Weschler Preschool and Primary Scale of Intelligence, 3rd edition (WPPSI-III, ages 3–5 years) and Weschler Intelligence Scale for Children, 4th edition (WISC-IV, ages 6–12 years). Continuous scores were analyzed using Kolmogorov-Smironov tests compared with a normal distribution (mean = 100 ± 15). Effect of covariates on Full-Scale Intelligence Quotient (FSIQ) was analyzed using linear regression. Results: Ninety-three participants completed 164 WPPSI-III (mean age 3.9) and 51 WISC-IV (mean age 6.9) tests. WPPSI-III FSIQ (104 ± 14, P 〈 0.02), Verbal IQ (106 ± 14, P 〈 0.001), and General Language Composite (107 ± 16, P 〈 0.001) distributions were shifted higher compared with test norms. WISC-IV FSIQ (105 ± 12, P 〈 0.01), Perceptual Reasoning Index (107 ± 12, P 〈 0.01), and Processing Speed Index (105 ± 10, P 〈 0.02) also shifted upwards. In univariate and multivariable analysis, parent education ( P 〈 0.01) was a significant predictor of FSIQ on WPPSI-III and positively associated with WISC-IV FSIQ. Male sex and higher total bilirubin and gamma glutamyl transferase (GGT) predicted lower WPPSI-III FSIQ. Portal hypertension was predictive of lower WISC-IV FSIQ. Conclusions: This cohort of children with BA and native liver did not demonstrate higher prevalence of neurodevelopmental delays. Markers of advanced liver disease (higher total bilirubin and GGT for age ≤5 years; portal hypertension for age ≥6) correlate with lower FSIQ and may identify a vulnerable subset of patients who would benefit from intervention.
Type of Medium:
Online Resource
ISSN:
0277-2116
,
1536-4801
DOI:
10.1097/MPG.0000000000002489
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2078835-6
