Eur J Pediatr Surg 2008; 18(2): 89-92
DOI: 10.1055/s-2007-965746
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Long-Term Cognitive Functions in Neonatal Short Bowel Syndrome Patients

J. Huang1 , W. Cai2 , Q. Tang1 , Y. Feng1 , Y. Tao3 , Y. Wang1 , J. Wu1
  • 1Clinical Nutrition Center, Shanghai Jiao Tong University, School of Medicine, Xin Hua Hospital, Shanghai, China
  • 2Department of Pediatric Surgery, Shanghai Jiao Tong University, School of Medicine, Xin Hua Hospital, Shanghai, China
  • 3Clinical Nutrition Center, Shanghai Institute of Pediatric Research, Shanghai, China
Further Information

Publication History

received May 22, 2007

accepted after revision August 21, 2007

Publication Date:
25 April 2008 (online)

Abstract

Objective: The aim of the study was to evaluate the long-term effects of neonatal short bowel syndrome on cognitive functions during development. Subjects and Methods: Nine patients diagnosed with short bowel syndrome during the neonatal period were enrolled in this study. Their medical records were reviewed; anthropometric measurements and blood tests were assayed; IQ tests (the Chinese versions of WAIS‐R, WPPSI‐R and WISC-R) were performed depending on their age, and a BSID assessment was carried out in those patients less than 4 years old. Results: Eight of 9 patients were followed up except for one patient who died in a car accident at the age of three. All patients had been weaned off parenteral nutrition for more than 2 years. The average residual small bowel length was 58.1 cm (range 35 - 70 cm), and the mean parenteral nutrition (PN) duration was 73.1 days (43 - 147 days). The mean duration of the period without PN was 7.4 years (range 2.1 - 17.1 years). Weight, height and BMI for age were normal in 7 children except for 1 child, who was overweight. Hemoglobin and albumin concentrations were normal in all 8 patients. Evaluation of cognitive development showed normal results for all 8 patients while a verbal/performance discrepancy was found in 2. Conclusion: Patients with neonatal SBS who were weaned off PN for more than 2 years were found to have normal growth and cognitive development during this long-term follow-up. There was no evidence for a strong correlation between SBS and nutritional/cognition disorder. Longer term and controlled studies with a larger sample size are warranted.

References

  • 1 Bayley N. Manual for the Bayley Scales of Infant Development. San Antonio; The Psychological Corporation 1969
  • 2 Beers S R. et al . Cognitive deficits in school-age children with severe short bowel syndrome.  J Pediatr Surg. 2000;  35 860-865
  • 3 Behrman R E. et al .Nelson Textbook of Pediatrics. 17th ed. Philadelphia; Elsevier Science 2004: 1604-1607
  • 4 DiBaise J K. et al . Intestinal rehabilitation and the short bowel syndrome: part 1.  Am J Gastroenterol. 2004;  99 1386-1395
  • 5 Dudrick S J. et al .Management of the short bowel syndrome. Miller TA, Dudrick SJ The Management of Difficult Surgical Problems. Austin, TX; University of Texas Press 1981: 170-179
  • 6 Goulet Q J. et al . Neonatal short bowel syndrome.  J Pediatr. 1991;  119 18-23
  • 7 Kuczmarski R J. et al . CDC growth charts for the United States: methods and development.  Vital Health Stat. 2002;  11 1-190
  • 8 Leonberg B L. et al . Long-term growth and development in children after home parenteral nutrition.  J Pediatr. 1998;  132 461-466
  • 9 Pniewska-Siark B. et al . Analysis of physical and mental development of children with aplasia, hypoplasia and ectopy of the thyroid gland.  Endocr Regul. 2006;  40 7-14
  • 10 Ponjaert-Kristoffersen I. et al . International collaborative study of intracytoplasmic sperm injection-conceived, in vitro fertilization-conceived, and naturally conceived 5-year-old child outcomes: cognitive and motor assessments.  Pediatrics. 2005;  115 e283-e289
  • 11 Quiros-Tejeira R E. et al . Long-term parenteral nutritional support and intestinal adaptation in children with short bowel syndrome: a 25-year experience.  J Pediatr. 2004;  145 157-163
  • 12 Wales P W. et al . Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates.  J Pediatr Surg. 2004;  39 690-695
  • 13 Wechsler D. Manual for the Wechsler Intelligence Scale for Children-Revised. New York, NY; Psychological Corp. 1974
  • 14 Wechsler D. Manual for the Wechsler Adult Intelligence Scale-Revised (WAIS‐R). New York, NY; Psychological Corp. 1981
  • 15 Wechsler D. Manual for the Wechsler Preschool and Primary Scale of Intelligence-Revised. New York, NY; Psychological Corp. 1990
  • 16 WHO/UNICEF/UNU .Iron deficiency anaemia: assessment, prevention, and control. Geneva; World Health Organization 2001 (WHO/NHD/01.3), http://www.who.int/reproductive-health/docs

Dr. Wei Cai

Department of Pediatric Surgery
Xin Hua Hospital, School of Medicine
Shanghai Jiao Tong University

Kong-Jiang Road

Yang-Pu District

Shanghai, 200092

China

Email: caiw204@yahoo.com.cn

    >