Original ArticleNeurodevelopment of Extremely Preterm Infants who had Necrotizing Enterocolitis with or without Late Bacteremia
Section snippets
Methods
The sample for this analysis is a subset of the 1506 infants enrolled in the ELGAN Study, a prospective cohort study designed to identify characteristics and exposures that increase the risk of structural and functional neurologic disorders in preterm infants.12 During the years 2002–2004, women delivering between 23 and 27 6/7 weeks of gestation at 1 of 14 participating institutions in 11 cities in 5 states were enrolled in the study. The enrollment and consent processes were approved by the
Results
Of the 1155 eligible children, 59 (5%) had medical NEC, 42 (4%) had surgical NEC, 70 (6%) had culture-proven early bacteremia, and 279 (24%) had culture-proven late bacteremia. The incidence of early bacteremia was not different in infants with and without NEC. In contrast, the incidence of late bacteremia was higher in infants with NEC than in those without NEC (34% vs 23%).
Table I documents the percent of infants in each diagnostic stratum (column headings) who were given the
Discussion
In this large prospective cohort of extremely preterm infants, infants who had development of medical NEC were not at statistically significantly increased risk of either any of the developmental disorders we assessed or of microcephaly. On the other hand, children who had surgical NEC without accompanying late bacteremia were at an increased risk of a PDI <70. Children who had development of surgical NEC and had culture-proven late bacteremia were at prominently increased risk of diparetic
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2022, Current Problems in Pediatric and Adolescent Health CareCitation Excerpt :The neonatal morbidity that has most consistently been associated with adverse neurodevelopmental outcomes is ultrasound-identified cerebral white matter injury.70,114-122 Less consistently, these adverse outcomes have been associated with severe bronchopulmonary dysplasia,123,124 necrotizing enterocolitis requiring surgery,62,125 sepsis,69,126 and severe retinopathy of prematurity.127-129 These neonatal morbidities co-occur so frequently that it is challenging to identify effects of individual factors.130
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All authors are members of the ELGAN Study Group.
Supported by a cooperative agreement with the National Institute of Neurological Diseases and Stroke (5U01NS040069-05) and a program project grant from the National Institute of Child Health and Human Development (NIH-P30-HD-18655). The authors declare no conflicts of interest.