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Hospital and neurodevelopmental outcomes of extremely low-birth-weight infants with necrotizing enterocolitis and spontaneous intestinal perforation

Journal of Perinatology volume 32, pages 552–558 (2012)Cite this article

Abstract

Objective:

We sought to determine the incidence of necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) in surviving extremely low-birth-weight (ELBW, <1000 g birth weight) infants and to establish the impact of NEC on outcomes by hospital discharge and at 18 to 22 months adjusted age in a large, contemporary, population-based practice.

Study Design:

Hospital outcome data for all ELBW infants born in the greater Cincinnati region from 1998 to 2009 were extracted from the National Institute of Child Health Neonatal Research Network Database. Neurodevelopmental outcome at 18 to 22 months was assessed using Bayley Scales of Infant Development-II scores for Mental Developmental Index and Psychomotor Developmental Index. Multivariable logistic regression was used and adjusted odds ratios reported to control for confounders.

Result:

From 1998 to 2009, ELBW infants accounted for 0.5% of the 352 176 live-born infants in greater Cincinnati. The incidence of NEC was 12%, with a 50% case-fatality rate. Death before discharge, morbid complications of prematurity and neurodevelopmental impairment were all increased among infants diagnosed with NEC. Infants with surgical NEC and SIP had a higher incidence of death, but long-term neurodevelopmental outcomes were not different comparing surviving ELBW infants with medical NEC, surgical NEC and SIP.

Conclusion:

Although ELBW infants comprise a very small proportion of live-born infants, those who develop NEC and SIP are at an increased risk for death, morbid complications of prematurity and neurodevelopmental impairment. No significant differences in neurodevelopmental outcomes were observed between the medical and surgical NEC and SIP groups.

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Acknowledgements

We thank the following individuals and hospital staff who contributed to this research: Eunice Kennedy Shriver NICHD NRN administrator (Estelle Fischer) and research coordinators and staff: (Kate Bridges, Cathy Grisby, Jody Hessling, Lenora Jackson, Kristin Kirker, Holly Mincey, Greg Muthig, Stacie Tepe). The NICU staffs at Cincinnati Children's Hospital Medical Center, Good Samaritan Hospital and University Hospital, Cincinnati. This work was supported in part by a grant from the National Institute of Child Health and Human Development Eunice Kennedy Shriver Neonatal Research Network (U10 HD 027853).

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Authors and Affiliations

  1. Department of Pediatrics, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    T A Shah, J Meinzen-Derr, T Gratton, J Steichen, B Alexander, V Narendran & K R Schibler

  2. Department of Pediatrics, Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    J Meinzen-Derr

  3. Department of Pediatrics, Child Policy Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    E F Donovan

  4. Department of Pediatrics, General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    K Yolton

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  1. T A Shah
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  7. B Alexander
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  9. K R Schibler
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Correspondence to K R Schibler.

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Shah, T., Meinzen-Derr, J., Gratton, T. et al. Hospital and neurodevelopmental outcomes of extremely low-birth-weight infants with necrotizing enterocolitis and spontaneous intestinal perforation. J Perinatol 32, 552–558 (2012). https://doi.org/10.1038/jp.2011.176

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