Hong Charles R, Fullerton Brenna S, Mercier Charles E, Morrow Kate A, Edwards Erika M, Ferrelli Karla R, Soll Roger F, Modi Biren P, Horbar Jeffrey D, Jaksic Tom
Center for Advanced Intestinal Rehabilitation, Department of Surgery, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
University of Vermont, 89 Beaumont Avenue, Burlington, VT 05405, USA.
J Pediatr Surg. 2018 Jun;53(6):1197-1202. doi: 10.1016/j.jpedsurg.2018.02.085. Epub 2018 Mar 8.
The purpose of this study was to examine postnatal growth outcomes and predictors of growth failure at 18-24months corrected age among extremely low birth weight (ELBW) survivors of necrotizing enterocolitis (NEC) compared to survivors without NEC.
Data were collected prospectively on ELBW (22-27weeks gestation or 401-1000g birth weight) infants born 2000-2013 at 46 centers participating in the Vermont Oxford Network follow-up project. Severe growth failure was defined as <3rd percentile weight-for-age.
There were 9171 evaluated infants without NEC, 416 with medical NEC, and 462 with surgical NEC. Rates of severe growth failure at discharge were higher among infants with medical NEC (56%) and surgical NEC (61%), compared to those without NEC (36%). At 18-24months follow-up, rates of severe growth failure decreased and were similar between without NEC (24%), medical NEC (24%), and surgical NEC (28%). On multivariable analysis, small for gestational age, chronic lung disease, severe intraventricular hemorrhage or cystic periventricular leukomalacia, severe growth failure at discharge, and postdischarge tube feeding predicted <3rd percentile weight-for-age at follow-up.
ELBW survivors of NEC have higher rates of severe growth failure at discharge. While NEC is not associated with severe growth failure at follow-up, one quarter of ELBW infants have severe growth failure at 18-24months.
Prognosis study.
II.
本研究旨在比较坏死性小肠结肠炎（NEC）极低出生体重（ELBW）存活者与无NEC存活者在矫正年龄18 - 24个月时的出生后生长结局及生长发育不良的预测因素。
前瞻性收集2000 - 2013年在46个参与佛蒙特牛津网络随访项目中心出生的ELBW（妊娠22 - 27周或出生体重401 - 1000g）婴儿的数据。严重生长发育不良定义为年龄别体重低于第3百分位数。
有9171名未患NEC的婴儿接受评估，416名患内科NEC，462名患外科NEC。与未患NEC的婴儿（36%）相比，患内科NEC（56%）和外科NEC（61%）的婴儿出院时严重生长发育不良的发生率更高。在18 - 24个月随访时，严重生长发育不良的发生率下降，未患NEC（24%）、内科NEC（24%）和外科NEC（28%）的婴儿之间相似。多变量分析显示，小于胎龄、慢性肺病、重度脑室内出血或脑室周围白质软化、出院时严重生长发育不良以及出院后管饲喂养可预测随访时年龄别体重低于第3百分位数。
NEC的ELBW存活者出院时严重生长发育不良的发生率更高。虽然NEC与随访时严重生长发育不良无关，但四分之一的ELBW婴儿在18 - 24个月时有严重生长发育不良。
预后研究。
II级。
