Department of Neonatology, Rigshospitalet, Copenhagen, Denmark.
Acta Paediatr. 2019 Oct;108(10):1911-1917. doi: 10.1111/apa.14789. Epub 2019 Apr 2.
To evaluate gastrointestinal sequelae and growth impairment at school age in children who suffered from necrotising enterocolitis (NEC).
This historic cohort study compared all surviving children born in Denmark between 1 January 2002 and 31 December 2011 with NEC in the newborn period, to surviving children without NEC, but same gestational age, birthweight and year of birth. Outcomes were investigated through a parental questionnaire, including gastrointestinal and growth-related outcomes. We performed exploratory ad hoc analysis, by adjusting for possible confounding and by dividing NEC children into surgical and medical.
In total, 163 children with NEC (50%) and 237 (36%) without NEC completed the parental questionnaire. Episodes of diarrhoea were more often reported in the NEC group (p = 0.0002). The increased risk seemed to be limited to those who underwent surgery for NEC. The absence from school (1.67 versus 1.31 days), rate of low height for age (17.9 versus 12.1%) and weight (29.9 versus 31.6 kg) did not differ significantly between children with NEC and children without NEC.
Our findings suggest that long-term gastrointestinal complications following NEC appeared to be of little clinical importance at the population level and therefore do not encourage specific routine follow-up.
评估患有坏死性小肠结肠炎（NEC）的儿童在学龄期的胃肠道后遗症和生长发育受损情况。
本历史队列研究比较了 2002 年 1 月 1 日至 2011 年 12 月 31 日期间在丹麦出生的所有患有新生儿期 NEC 的存活儿童，与没有 NEC 但具有相同胎龄、出生体重和出生年份的存活儿童。通过家长问卷调查评估结局，包括胃肠道和生长相关结局。我们进行了探索性的特设分析，通过调整可能的混杂因素，并将 NEC 患儿分为手术和非手术组。
共有 163 名 NEC 患儿（50%）和 237 名（36%）无 NEC 患儿完成了家长问卷调查。NEC 组腹泻发作更为常见（p=0.0002）。这种风险增加似乎仅限于接受 NEC 手术的患儿。NEC 患儿缺课（1.67 天比 1.31 天）、身高低于年龄（17.9%比 12.1%）和体重低于年龄（29.9 公斤比 31.6 公斤）的比例与无 NEC 患儿无显著差异。
我们的研究结果表明，NEC 后长期胃肠道并发症在人群水平上似乎没有明显的临床意义，因此不鼓励进行特定的常规随访。
