Intestinal perforation in very low birth weight infants: growth and neurodevelopment at 1 year of age.
OBJECTIVE
To compare growth and neurodevelopment in surviving very low birth weight (VLBW) infants with an intestinal perforation (IP) caused by necrotizing enterocolitis (NEC) versus spontaneous intestinal perforation (SIP).


METHODS
Retrospective, observational cohort study. Infants born between January 1996 and December 1999 with birth weight <1500 g and a diagnosis of intestinal perforation were identified and data extracted from NICU, surgical and hospital databases.


RESULTS
IP was identified in 62 of 1357 VLBW infants (5%); 39 infants (63%) had surgical NEC and 23 (37%) had SIP. Among survivors, 21/28 with surgical NEC (75%) and 13/18 with SIP (72%) returned for follow-up. At 1-year adjusted age, there were no differences in growth parameters but the Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) were lower in survivors with NEC versus SIP (mean difference in MDI=15; 95% confidence limits=3, 28; p=0.02; mean difference in PDI=14; 95% confidence limits=0.4, 28; p=0.04).


CONCLUSIONS
Intestinal perforation caused by NEC, as compared to SIP, is associated with worse neurodevelopmental outcome at 1 year.
Adesanya
Olubukunola A
OA
Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
O'Shea
T Michael
TM
Turner
Charles S
CS
Amoroso
Robert M
RM
Morgan
Timothy M
TM
Aschner
Judy L
JL
D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D020345:Enterocolitis, Necrotizing / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D011597:Psychomotor Performance; D012189:Retrospective Studies