Neonatal onset intestinal failure: an Italian Multicenter Study.
OBJECTIVE
To describe the natural course of intestinal failure with onset in the neonatal period to provide data regarding the occurrence and to provide a population-based survey regarding the spectrum of underlying diseases.


METHODS
We performed a retrospective chart review including infants admitted to the neonatal intensive care unit of 7 Italian tertiary care centers. Intestinal failure was defined as a primary intestinal disease that induces the need of total parenteral nutrition (PN) for more than 4 weeks or the need of partial PN for more than 3 months.


RESULTS
The total number of live births during the study time within the enrolled institutions was 30 353, and the number of newborns admitted to the neonatal intensive care unit was 5088. Twenty-six patients satisfied the definition of intestinal failure; thus the occurrence rate of intestinal failure was 0.1% among live-birth newborns and 0.5% among infants at high risk. The main underlying diseases leading to intestinal failure in neonatal age were congenital intestinal defects (42.3%), necrotizing enterocolitis (30.8%), severe intestinal motility disorder (11.5%), intestinal obstruction (7.7%), structural enterocyte defects (3.8%), and meconium peritonitis (3.8%). After a follow-up of 36 months, 84.6% of patients achieved intestinal competence, 1 patient was still receiving home PN, 1 patient underwent transplantation, and 2 patients died. Cholestatic liver disease was diagnosed in 54% of observed children.


CONCLUSIONS
An understanding of the incidence, causes, and natural history of intestinal failure would be helpful to appropriately allocate resources and to plan clinical trials.
Salvia
Gennaro
G
NICU Buon Consiglio Fatebenefratelli Hospital of Naples, Naples, Italy. salvia@unina.it
Guarino
Alfredo
A
Terrin
Gianluca
G
Cascioli
Concetta
C
Paludetto
Roberto
R
Indrio
Flavia
F
Lega
Laura
L
Fanaro
Silvia
S
Stronati
Mauro
M
Corvaglia
Luigi
L
Tagliabue
Paolo
P
De Curtis
Mario
M
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology*; D007558:Italy; D008297:Male; D008954:Models, Biological; D010288:Parenteral Nutrition; D012189:Retrospective Studies; D012306:Risk; D012778:Short Bowel Syndrome / Q000175:diagnosis / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome