TY - JOUR
T1 - Early Motor Repertoire in Infants With Biliary Atresia
T2 - A Nationwide Prospective Cohort Study
AU - Rodijk, Lyan H
AU - Bos, Arend F
AU - Verkade, Henkjan J
AU - de Kleine, Ruben H
AU - Hulscher, Jan B F
AU - Bruggink, Janneke L M
N1 - Copyright © 2020 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology.
PY - 2021/4
Y1 - 2021/4
N2 - OBJECTIVES: To assess the neurological status in infants with biliary atresia (BA) at time of diagnosis, using Prechtl's validated General Movement Assessment (GMA).METHODS: Infants diagnosed with BA were prospectively included in a nationwide cohort study. From birth to approximately 46 weeks of postmenstrual age (PMA), General Movements (GMs) are defined as 'writhing movements'. At 46 to 49 weeks PMA, 'fidgety movements' emerge. The infant's early motor repertoire was recorded on video before Kasai portoenterostomy. We scored GM Optimality Scores (GMOS, min-max 5-42) or Motor Optimality Scores (MOS, min-max 5-28) as appropriate. We defined GMOS <36 and MOS <26 as atypical, and compared the results with two reference groups of healthy peers.RESULTS: We assessed GMs in 35 infants with BA (11/35 boys, gestational age 40 weeks [36-42], birth weight 3370 gram [2015-4285]). At time of diagnosis (PMA 47 weeks [42-60]), 16 infants (46%) showed atypical GMs. The proportion of infants with atypical GMs was significantly higher in BA (46%) than in two reference groups of healthy infants (vs 10%, p<0.001; vs 18%, p < 0.001). Total and direct bilirubin levels were 165 μmol/L [87-364] and 134 μmol/L [72-334], respectively, height Z-score was 0.05 [-2.90, 1.75], weight Z-score -0.52 [-2.50, -0.20] and MUAC Z-score -1.80 [-2.50, -0.20]. We found no statistically significant relation between atypical GMs and clinical variables.CONCLUSIONS: Almost half of the infants with BA showed atypical GMs at time of diagnosis, suggesting neurological impairment. Close monitoring of these infants is warranted to determine their individual neurodevelopmental trajectories.
AB - OBJECTIVES: To assess the neurological status in infants with biliary atresia (BA) at time of diagnosis, using Prechtl's validated General Movement Assessment (GMA).METHODS: Infants diagnosed with BA were prospectively included in a nationwide cohort study. From birth to approximately 46 weeks of postmenstrual age (PMA), General Movements (GMs) are defined as 'writhing movements'. At 46 to 49 weeks PMA, 'fidgety movements' emerge. The infant's early motor repertoire was recorded on video before Kasai portoenterostomy. We scored GM Optimality Scores (GMOS, min-max 5-42) or Motor Optimality Scores (MOS, min-max 5-28) as appropriate. We defined GMOS <36 and MOS <26 as atypical, and compared the results with two reference groups of healthy peers.RESULTS: We assessed GMs in 35 infants with BA (11/35 boys, gestational age 40 weeks [36-42], birth weight 3370 gram [2015-4285]). At time of diagnosis (PMA 47 weeks [42-60]), 16 infants (46%) showed atypical GMs. The proportion of infants with atypical GMs was significantly higher in BA (46%) than in two reference groups of healthy infants (vs 10%, p<0.001; vs 18%, p < 0.001). Total and direct bilirubin levels were 165 μmol/L [87-364] and 134 μmol/L [72-334], respectively, height Z-score was 0.05 [-2.90, 1.75], weight Z-score -0.52 [-2.50, -0.20] and MUAC Z-score -1.80 [-2.50, -0.20]. We found no statistically significant relation between atypical GMs and clinical variables.CONCLUSIONS: Almost half of the infants with BA showed atypical GMs at time of diagnosis, suggesting neurological impairment. Close monitoring of these infants is warranted to determine their individual neurodevelopmental trajectories.
KW - cholestasis
KW - general movement assessment
KW - liver disease
KW - neurological status
U2 - 10.1097/MPG.0000000000003021
DO - 10.1097/MPG.0000000000003021
M3 - Article
C2 - 33346571
SN - 0277-2116
VL - 72
SP - 592
EP - 596
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 4
ER -