Necrotizing Enterocolitis and Neurodevelopmental Outcome in Extremely Low Birth Weight Infants <1000 g.
Salhab, Walid A. MD; Perlman, Jeffrey M. MB; Silver, Lori BS; Broyles, R. Sue MD
[Article] Journal of Perinatology. 24(9):534-540, September 2004.

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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.

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