Soraisham Amuchou S, Amin Harish J, Al-Hindi Mohammed Y, Singhal Nalini, Sauve Reginald S
Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
J Paediatr Child Health. 2006 Sep;42(9):499-504. doi: 10.1111/j.1440-1754.2006.00910.x.
To compare the long-term growth and neurodevelopmental outcomes at 36 months adjusted age in preterm infants (birthweight (BW) < or = 1250 g) with necrotising enterocolitis (NEC) with BW-matched controls.
This is a case control study performed at a regional tertiary care neonatal intensive care unit. Infants with stage II or III NEC admitted to a regional tertiary care neonatal unit between 1995 and 2000 were identified. Each infant with NEC was matched by BW (+/-100 g) to next two infants admitted in the unit without NEC. Growth and neurodevelopmental outcomes at 36 months are compared.
In total, 51 infants with NEC and 102 controls met study eligibility criteria and 146/153 (94.3%) were prospectively followed for 36 months. Infants with NEC had more culture-proven sepsis (35.3% vs. 10.8%, P < 0.001); patent ductus arteriosus requiring therapy (64.7% vs. 45%, P = 0.02), chronic lung disease (60.7% vs. 45%, P = 0.04) and longer hospital stay (84 days vs. 71 days, P < 0.0001). There were no significant differences in growth outcomes between the two groups at 36 months. Overall 24% of infants with NEC had one major neurodevelopmental disability compared with 10% among control infants. Infants who developed NEC had significantly higher cognitive delay (i.e. cognitive index <70) and visual impairment. A logistic regression model identified NEC as a predictor of cognitive delay.
Preterm infants who develop NEC are at a significantly higher risk for developing neurodevelopmental disability. We recommend close neurodevelopmental follow up for all < or =1250 g infants who develop stage II or III NEC.
比较出生体重（BW）≤1250g的坏死性小肠结肠炎（NEC）早产儿与体重匹配的对照早产儿在36个月矫正年龄时的长期生长及神经发育结局。
这是一项在地区三级医疗新生儿重症监护病房开展的病例对照研究。确定1995年至2000年间入住地区三级医疗新生儿病房的II期或III期NEC婴儿。将每名NEC婴儿按体重（±100g）与接下来入住该病房的两名无NEC婴儿进行匹配。比较36个月时的生长及神经发育结局。
共有51例NEC婴儿和102例对照符合研究纳入标准，146/153（94.3%）被前瞻性随访36个月。NEC婴儿有更多经培养证实的败血症（35.3%对10.8%，P<0.001）；需要治疗的动脉导管未闭（64.7%对45%，P=0.02）、慢性肺病（60.7%对45%，P=0.04），且住院时间更长（84天对71天，P<0.0001）。两组在36个月时的生长结局无显著差异。总体而言，24%的NEC婴儿有一项主要神经发育残疾，而对照婴儿中这一比例为10%。发生NEC的婴儿有显著更高的认知延迟（即认知指数<70）和视力损害。逻辑回归模型确定NEC是认知延迟的一个预测因素。
发生NEC的早产儿发生神经发育残疾的风险显著更高。我们建议对所有发生II期或III期NEC的≤1250g婴儿进行密切的神经发育随访。
