Abstract Objective To investigate the long-term prognosis of neonates with necrotizing enterocolitis (NEC).Methods A total of 83 preterm infants with NEC who survived and were discharged between December 2014 and September 2016 were enrolled and divided into surgery group (n=57) and non-surgery group (n=26). There were 0, 33 and 24 cases of stage I, Ⅱ and Ⅲ NEC respectively in the surgery group and 7, 19 and 0 cases respectively in the non-surgery group. The physical development and neurodevelopmental outcomes of the infants were followed up after discharge.Results Of the 83 infants, the mean corrected age at the end of follow-up was 21±6 months. Of the 83 infants, 31 (37%) had subnormal body weight, and the surgery group had a higher rate of subnormal body weight than the non-surgery group (P < 0.05). Twenty-two infants (27%) had subnormal body length and 14 children (17%) had subnormal head circumference among the 83 infants. Eighteen infants (22%) had motor developmental delay/developmental disorders, and the surgery group had a higher incidence rate of the disorders than the non-surgery group (28% vs 8%; P < 0.05). Five infants (6%) were diagnosed with cerebral palsy, among whom 4 were in the surgery group and 1 was in the non-surgery group.Conclusions Long-term physical development and neurodevelopmental outcomes may be adversely affected in neonates with NEC, in particular in those with severe conditions who need surgical treatment, suggesting that long-term follow-up should be performed for neonates with NEC.
Eltayeb AA, Mostafa MM, Ibrahim NH, et al. The role of surgery in management of necrotizing enterocolitis[J]. Int J Surg, 2010, 8(6):458-461.
[3]
Neu J, Walker WA. Necrotizing enterocolitis[J]. N Engl J Med, 2011, 364(3):255-264.
[4]
Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging[J]. Ann Surg, 1978, 187(1):1-7.
[5]
WHO. WHO Child Growth Standards:methods and development[EB/OL].[2018-06-10].
[6]
Cloherty JP, Eichenwald EC, Hansen AR, et al. Manual of Neonatal Care[M]. 7th ed. Philadelphia:Little, Brown and Company, 2012:762-766.
Fitzgibbons SC, Ching Y, Yu D, et al. Mortality of necrotizing enterocolitis expressed by birth weight categories[J]. J Pediatr Surg, 2009, 44(6):1072-1075.
[12]
Lin HJ, Du LZ, Ma XL, et al. Mortality and morbidity of extremely low birth weight infants in the mainland of China:a multi-center study[J]. Chin Med J (Engl), 2015, 128(20):2743-2750.
Petty JK, Ziegler MM. Operative strategies for necrotizing enterocolitis:the prevention and treatment of short-bowel syndrome[J]. Semin Pediatr Surg, 2005, 14(3):191-198.
[16]
Lawlor DA, Batty GD, Morton SM, et al. Early life predictors of childhood intelligence:evidence from the Aberdeen children of the 1950s study[J]. J Epidemiol Community Health, 2005, 59(8):656-663.
[17]
Walsh MC, Kliegman RM, Hack M. Severity of necrotizing enterocolitis:influence on outcome at 2 years of age[J]. Pediatrics, 1989, 84(5):808-814.
[18]
Salhab WA, Periman JM, Sliver L, et al. Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants <1000 g[J]. J Perinatol, 2004, 24(9):534-540.
[19]
Hintz SR, Kendrick DE, Stoll BJ, et al. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis[J]. Pediatrics, 2005, 115(3):696-703.
[20]
Sonntag J, Grimmer I, Scholz T, et al. Growth and neuro-developmental outcome of very low birthweight infants with necrotizing enterocolitis[J]. Acta Paediatr, 2000, 89(5):528-532.
[21]
Dilli D, Eras Z, Özkan Ulu H, et al. Does necrotizing enterocolitis affect growth and neurodevelopmental outcome in very low birth weight infants?[J]. Pediatr Surg Int, 2012, 28(5):471-476.
[22]
Rees CM, Pierro A, Eaton S. Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis[J]. Arch Dis Child Fetal Neonatal Ed, 2007, 92(3):F193-F198.
[23]
Arnold M, Moore SW, Sidler D, et al. Long-term outcome of surgically managed necrotizing enterocolitis in a developing country[J]. Pediatr Surg Int, 2010, 26(4):355-360.
[24]
Schulzke SM, Deshpande GC, Patole SK. Neurodevelopmental outcomes of very low-birth-weight infants with necrotizing enterocolitis:a systematic review of observational studies[J]. Arch Pediatr Adolesc Med, 2007, 161(6):583-590.