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Necrotizing Enterocolitis and Neurodevelopmental Outcome in Extremely Low Birth Weight Infants <1000 g

Abstract

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).

STUDY DESIGN: 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.

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Presented in Part at the Southern Society for Pediatric Research February 2002.

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Salhab, W., Perlman, J., Silver, L. et al. Necrotizing Enterocolitis and Neurodevelopmental Outcome in Extremely Low Birth Weight Infants <1000 g. J Perinatol 24, 534–540 (2004). https://doi.org/10.1038/sj.jp.7211165

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