Long Term Outcome of Infants with NEC

Abstract

: Necrotizing enterocolitis (NEC) is an important complication for premature newborns. Infants who survive NEC have a greater possibility of poor long-term physiological and neurodevelopmental growth. : The objective of this paper is to give a comprehensive description of the long-term consequences of NEC. Despite the rise in incidence of NEC there is a scarcity of data regarding long-term outcomes of these infants that can be divided into two groups. The first group includes gastrointestinal complications that could occur in relation to the bowel disease, the surgical treatment and quality of the residual bowel. These complications are strictures and short bowel syndrome (SBS). : Intestinal strictures are a common occurance after recovery from NEC that should be investigated with a contrast study in case of suspicious clinical findings of bowel obstruction or before reversal ostomy. After this diagnostic investigation, if a stricture is detected in a symptomatic patient, resection of the affected loop of bowel with anastomosis is required. SBS is the result of a massive intestinal resection or of a dysfunctional residual bowel and it can occur in a fourth of patients affected by NEC. : The second group includes neurodevelopmental impairment and growth. : Infants with NEC is a population of patients at high risk for adverse neurodevelopmental outcomes whose cause can be multifactorial and linked to perinatal events, severity of disease, surgical treatment and its complications and hospitalization. Understanding the morbidity of NEC with a longterm follow-up would aid neonatologists and pediatric surgeons to make informed decisions in providing care for these patients. Further research on this topic is needed. : Neurodevelopmental outcomes of patients after NEC recovery have not been widely reported.

Effect of single versus multistrain probiotic in extremely preterm infants: a randomised trial

“…Late-onset sepsis (LOS) and necrotising enterocolitis (NEC ≥stage II) contribute to significant mortality and morbidity, including long-term growth and neurodevelopment in preterm infants, especially those born before 28 weeks' gestation. [1][2][3] Recently, NEC and LOS have been shown to be preceded by gut dysbiosis. [4][5][6] Preterm infants are at a high risk of gut dysbiosis due to gut immaturity further complicated by environmental exposures (eg, mode of delivery, chorioamnionitis and neonatal intensive care), feeding intolerance and antibiotic exposure.…”

Impact of Different Types of Nosocomial Infection on the Neurodevelopmental Outcome of Very Low Birth Weight Infants

“…One study detected a significant influence of all types of nosocomial infections on neurodevelopmental outcomes [8], while another study found a higher risk of cerebral palsy only in infants with Gram-positive nosocomial infections at 2 years of corrected age [23]. As for NEC, multiple studies have reported a strong association with adverse neurodevelopmental outcomes, particularly cerebral palsy [30,31].…”

Analysis of Factors Associated With Body Mass Index at Ages 18 and 36 Months Among Infants Born Extremely Preterm

“…The variables were selected using previous reports of factors associated with subsequent body composition. [33][34][35][36][37][38][39][40] LCC is a form of hypotension that occurs after the early neonatal period with unclear underlying pathology that is common in Japan but not widely known in North America or Europe. 41 We calculated BMI at ages 18 months and 36 months using weight and height.…”

“…Gestational age was rescaled so that a value of 0 corresponded to gestational age 23 weeks so that the intercept term measured the BMI for an infant born without IUGR at gestational age 23 weeks. Parity, complications during pregnancy, and hospital stay, which were reported in previous studies [33][34][35][36][37][38][39][40] to be associated with subsequent outcomes, were included as covariates. A backward stepwise model-building method was used to remove nonsignificant covariates.…”