Peer-reviewed article
Motor and cognitive outcomes in pediatric intestinal failure: A longitudinal cohort study.
Gold A, Patterson C, Belza C, Johnson D, Bondi BC et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed 41 children with intestinal failure from infancy through early school age to track their motor and cognitive development. Children showed below-average gross motor skills in preschool years but improved by school age, while fine motor and cognitive scores dipped around 2-2.5 years old before recovering. Risk factors for poorer outcomes included low birth weight, early motor delays, nervous system problems, and prolonged hospitalization. The findings suggest that while children with intestinal failure face developmental challenges in early years, many make significant gains by school age.
Key points
- Gross motor scores were below average at preschool timepoints but showed significant improvement by school age
- Fine motor and cognitive scores decreased at 26-32 months corrected age compared to earlier and later assessments
- Risk factors for poorer developmental outcomes included birth weight, early motor delay, CNS co-morbidity, auditory impairment, necrotizing enterocolitis, surgeries, sepsis, and prolonged hospitalization
- Study population median gestational age was 33 weeks with median first-year hospitalization of 209 days
- Only 5 children (12%) had CNS co-morbidities in the cohort
Limitations
The study does not specify the country or institution where the research was conducted. The relatively small sample size (41 children) and single-cohort design limit generalizability of findings to other populations or healthcare settings.
Abstract
Background Improved survival in pediatric intestinal failure (IF) necessitates a focus on neurodevelopmental outcomes. Existing cross-sectional research demonstrates increased risk of developmental delay. This novel study explores longitudinal motor and cognitive outcomes, and associated risk factors, in a single cohort across infancy to early school age. Material and methods Retrospective review of children admitted to an IF program < 4 months of age between 2011 and 2016, who completed: motor assessment between 4 and 15 months corrected age (CA), motor and cognitive assessment between 12 and 32 months CA and 4-8 years. Descriptive analysis of medical, socio-demographic variables and assessment scores. Outcomes were assessed using linear mixed methods, with multi-variable analyses to explore main effects and significant interactions with time. Results Study population included 41 children (56% male), median (IQR) gestational age 33 (28.5, 35.5) weeks and length of first year hospitalization 209 (140.8, 255) days. Five children (12%) had central nervous system (CNS) co-morbidities. Gross motor scores were below average at pre-school time-points, with significant improvement by school age; whereas fine motor and cognitive scores significantly decreased at 26-32 months CA, compared to largely average scores at 12-15-months CA and school age. Main effects predicting poorer scores included: birth weight, early motor delay, CNS co-morbidity, auditory impairment, NEC diagnosis, surgeries, sepsis, and prolonged hospitalization. Conclusions Children with IF demonstrate developmental vulnerably in infancy and preschool years, with promising motor and cognitive gains observed by early school age. Identification of key risk factors can guide IF teams in providing targeted therapeutic interventions, mitigating longer term developmental risks.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Standard care provided in an intestinal failure program with longitudinal developmental monitoring and assessment
- Population
- 41 children (56% male, median gestational age 33 weeks) admitted to an intestinal failure program before 4 months of age between 2011 and 2016
Key finding
Gross motor scores were below average at preschool timepoints with significant improvement by school age