Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants < 1000 g

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. © 2004 Nature Publishing Group All rights reserved.