title: Outcomes at 7 years for babies who developed neonatal necrotising enterocolitis: the ORACLE Children Study.
abstract: BACKGROUND
  Within the ORACLE Children Study Cohort, the authors have evaluated long-term consequences of the diagnosis of confirmed or suspected neonatal necrotising enterocolitis (NEC) at age of 7 years.
  
  
  METHODS
  Outcomes were assessed using a parental questionnaire, including the Health Utilities Index (HUI-3) to assess functional impairment, and specific medical and behavioural outcomes. Educational outcomes for children in England were explored using national standardised tests. Multiple logistic regression was used to explore independent associates of NEC within the cohort.
  
  
  RESULTS
  The authors obtained data for 119 (77%) of 157 children following proven or suspected NEC and compared their outcomes with those of the remaining 6496 children. NEC was associated with an increase in risk of neonatal death (OR 14.6 (95% CI 10.4 to 20.6)). At 7 years, NEC conferred an increased risk of all grades of impairment. Adjusting for confounders, risks persisted for any HUI-3 defined functional impairment (adjusted OR 1.55 (1.05, 2.29)), particularly mild impairment (adjusted OR 1.61 (1.03, 2.53)) both in all NEC children and in those with proven NEC, which appeared to be independent. No behavioural or educational associations were confirmed. Following NEC, children were more likely to suffer bowel problems than non-NEC children (adjusted OR 3.96 (2.06, 7.61)).
  
  
  CONCLUSIONS
  The ORACLE Children Study provided opportunity for the largest evaluation of school age outcome following neonatal NEC and demonstrates significant long-term consequences of both gut function (presence of stoma, admission for bowel problems and continuing medical care for gut-related problems) and motor, sensory and cognitive outcomes as measured using HUI-3.
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Pike
authors.forename: Peter
authors.initials: P
authors.lastname: Brocklehurst
authors.forename: David
authors.initials: D
authors.lastname: Jones
authors.forename: Sarah
authors.initials: S
authors.lastname: Kenyon
authors.forename: Alison
authors.initials: A
authors.lastname: Salt
authors.forename: David
authors.initials: D
authors.lastname: Taylor
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D020345:Enterocolitis, Necrotizing / Q000150:complications*; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011795:Surveys and Questionnaires; D006113:United Kingdom