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.
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.
Authors: Camilia R Martin; Olaf Dammann; Elizabeth N Allred; Sonal Patel; T Michael O'Shea; Karl C K Kuban; Alan Leviton Journal: J Pediatr Date: 2010-07-02 Impact factor: 4.406