Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants <1000 g.

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.