Neurodevelopmental Outcome of Extremely Low Birth Weight Infants with Cholestasis at 12 and 24 Months

Abstract

<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> For assessment of neurodevelopmental outcome (Bayley-III), 174 infants were available at 12-month (PNAC: <i>n</i> = 21; no PNAC: <i>n</i> = 153) and 164 infants at 24-month (PNAC: <i>n</i> = 20; no PNAC: <i>n</i> = 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. <b><i>Conclusion:</i></b> ELBW infants with PNAC are at increased risk for adverse neurodevelopmental outcome.