title: Developmental assessment of infants with biliary atresia:  differences between boys and girls.
abstract: OBJECTIVE
  The aim of the present study was to investigate whether male and female infants with biliary atresia (BA) differ cognitively and to confirm previously documented developmental lags in infants with BA before liver transplantation.
  
  
  METHODS
  With the Mullen Scales of Early Learning, we examined 21 female and 12 male infants (ages 3-20 months) with BA, comparing scores across indices by sex and correlating Mullen Scales of Early Learning scores with standard clinical and biochemical parameters.
  
  
  RESULTS
  Overall, both boys and girls were found to be vulnerable to developmental lags in the areas of expressive language (EL) and gross motor skills. In comparison with their male peers, girls were found to be weaker in the area of visual reception skills (P=0.05) with a trend found for EL (P=0.08). Girls were also found to have higher C-bilirubin levels and to be of shorter length. Growth parameters were found to be correlated with EL scores. International normalized ratio was found to be correlated with gross motor performance and with a trend also noted for fine motor skills. Age at Kasai predicted receptive language skills.
  
  
  CONCLUSIONS
  As has been shown, infants with BA appear to be vulnerable to developmental lags before transplantation. In particular, female infants appear to be vulnerable to cognitive and skill delays in comparison with their male peers. C-bilirubin levels may play a role in this increased vulnerability for females.
authors.affiliation: Section of Psychology, Psychology Service, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA. secaudle@texaschildrens.org
authors.forename: Susan E
authors.initials: SE
authors.lastname: Caudle
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Katzenstein
authors.forename: Saul
authors.initials: S
authors.lastname: Karpen
authors.forename: Valérie
authors.initials: V
authors.lastname: McLin
mesh_terms: D001656:Biliary Atresia / Q000150:complications* / Q000523:psychology; D001663:Bilirubin / Q000097:blood; D001827:Body Height; D002657:Child Development; D003071:Cognition; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D007802:Language; D007805:Language Development Disorders / Q000209:etiology*; D016031:Liver Transplantation; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D012737:Sex Factors; D014785:Vision, Ocular; D014796:Visual Perception / Q000502:physiology*
chemical_list: D001663:Bilirubin