Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants <1000 g.
OBJECTIVE
To determine the growth and neurodevelopmental outcome, as well as predictors of the latter in extremely low-birth-weight (ELBW) infants with definitive necrotizing enterocolitis (NEC).


METHODS
Case - control analysis. In all, 17 ELBW infants <1000 g with Stage 2 or 3 NEC were matched to 51 control infants without NEC. Demographics, clinical course, growth, and neurodevelopmental outcome were compared.


RESULTS
Demographic and clinical characteristics of both groups were similar except that NEC infants had more culture-proven sepsis (59 vs 24%, p=0.02), longer intubation (36 vs 16 days, p=0.003) and longer hospital stay (134 vs 86 days, p<0.001). At 18 to 22 months corrected age BSID-II mental scores (MDI) were similar between groups (74+/-14 vs 81+/-13, p=0.2). However, the psychomotor index (PDI) (66+/-18 vs 88+/-14), the proportion with abnormal neurologic examination (54 vs 9%), subnormal height (38 vs 3%) and head circumference (23 vs 0%) were significantly higher in NEC infants (p<0.05). A logistic model identified NEC and chronic lung disease as predictors for abnormal PDI and MDI, respectively.


CONCLUSIONS
NEC and its comorbidities are associated with severe neurodevelopmental and growth delay in ELBW infants.
Salhab
Walid A
WA
Department of Pediatrics, Division of Neonatal-Perinatal Medicine University of Texas Southwestern Medical Center Dallas, TX, USA.
Perlman
Jeffrey M
JM
Silver
Lori
L
Sue Broyles
R
R
D016022:Case-Control Studies; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology; D020345:Enterocolitis, Necrotizing / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D019102:Infant, Very Low Birth Weight; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D009460:Neurologic Examination; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D013997:Time Factors