Kristjánsson Júlíus, Sävman Karin, Allvin Kerstin, Elfvin Anders
Department of Paediatrics, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Region Västra Götaland, Department of Paediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Paediatr. 2025 Jun;114(6):1259-1266. doi: 10.1111/apa.17560. Epub 2024 Dec 23.
To evaluate whether extremely preterm infants with considerable gastrointestinal (GI) symptoms during the neonatal period, but without major abdominal surgery or necrotising enterocolitis, had an increased probability of developing GI dysfunction later in life.
A retrospective, case-control study on extremely preterm neonates that underwent an upper gastrointestinal contrast series (UGI) between 2012 and 2017, with UGI used as a marker of considerable GI symptoms. Controls were matched for sex and gestational age. The primary outcome was GI dysfunction requiring ongoing medical support at 5.5 years. Secondary outcomes included respiratory, neurological and growth abnormalities.
Thirty-three patients and 66 controls were included; mean gestational age at birth was 25w + 4d. Cases had an odds ratio of 3.8 (p = 0.005; 95% CI = 1.47-9.82) for developing GI dysfunction at 5.5 years after adjusting for confounders. Neonatal morbidities of sepsis, patent ductus arteriosus and hypothyroidism were more common in cases (p < 0.05). No differences were seen in secondary outcomes at 5.5 years of age.
Extremely preterm infants with unexplained GI symptoms during the neonatal period had increased odds of developing GI dysfunction later in life, which was not explained by other morbidities. We suggest appropriate attention concerning later GI dysfunction in these patients.
评估在新生儿期有明显胃肠道（GI）症状，但未接受重大腹部手术或坏死性小肠结肠炎的极早产儿，在以后的生活中发生胃肠功能障碍的可能性是否增加。
一项对2012年至2017年间接受上消化道造影系列检查（UGI）的极早产儿进行的回顾性病例对照研究，将UGI用作明显GI症状的标志物。对照组按性别和胎龄进行匹配。主要结局是在5.5岁时需要持续医疗支持的胃肠功能障碍。次要结局包括呼吸、神经和生长异常。
纳入33例患者和66例对照；出生时的平均胎龄为25周+4天。校正混杂因素后，病例在5.5岁时发生胃肠功能障碍的比值比为3.8（p=0.005；95%CI=1.47-9.82）。败血症、动脉导管未闭和甲状腺功能减退等新生儿疾病在病例中更常见（p<0.05）。5.5岁时次要结局未见差异。
新生儿期有不明原因GI症状的极早产儿在以后的生活中发生胃肠功能障碍的几率增加，这不能用其他疾病来解释。我们建议对这些患者后期的胃肠功能障碍给予适当关注。
