Neurodevelopmental Outcomes of Neonates with Medically and Surgically Treated Necrotizing Enterocolitis

Overview

Journal Arch Dis Child Fetal Neonatal Ed

Specialties Gynecology & Obstetrics
Pediatrics

Date 2006 Sep 21

PMID 16984980

Citations 137

Authors

Clare M Rees

Agostino Pierro

Simon Eaton

Affiliations

Soon will be listed here.

Abstract

Objectives: (1) To characterise neurodevelopmental outcome of neonates with necrotizing enterocolitis (NEC); (2) to define whether NEC increases risk of neurodevelopmental impairment in very low birth weight neonates; (3) to investigate whether stage of disease or need for surgery increase risk of poor outcome.

Design: A systematic review was performed. Searches identified 182 relevant papers. Ten studies compared extremely low birthweight neonates with NEC to infants of similar age and gestation who did not develop NEC. Data are reported as OR (95% CIs, p values for test for overall effect) and compared by chi2.

Results: 7843 children (821 with NEC) were included in the meta-analysis. Median follow-up was 20 months (range 12 to 156). Overall, 45% of children who had neonatal NEC were neurodevelopmentally impaired. Infants with NEC were significantly more likely than infants of similar age and gestation who did not develop NEC to be neurodevelopmentally impaired (1.6 (1.3 to 2.0), p = 0.0001) including a higher risk of cerebral palsy (1.5 (1.2 to 2.0), p = 0.001), visual (2.3 (1.0 to 5.1), p = 0.04), cognitive (1.7 (1.4 to 2.2), p<0.0001) and psychomotor impairment (1.7 (1.3 to 2.2), p<0.0001). The odds ratio of neurodevelopmental impairment was also 2.3 times higher in neonates with Bell's stage III disease or requiring surgery ((1.5 to 3.6), p = 0.0001).

Conclusions: NEC is associated with significantly worse neurodevelopmental outcome than prematurity alone. Presence of advanced NEC and need for surgery increase the risk of neurological impairment.

Citing Articles

Glucagon-like peptides agonists promote maturation of intestinal organoids derived from neonates with necrotizing enterocolitis.

Biouss G, Lee C, Li B, Adeli K, Pierro A Pediatr Surg Int. 2025; 41(1):69.

PMID: 39828765 DOI: 10.1007/s00383-024-05957-w.

Characteristics, progression, management, and outcomes of NEC: a retrospective cohort study.

Shahroor M, Elkhouli M, Lee K, Pierro A, Shah P Pediatr Surg Int. 2024; 41(1):13.

PMID: 39614013 DOI: 10.1007/s00383-024-05918-3.

Time to recovery from necrotizing enterocolitis and its predictors among neonates admitted to Neonatal Intensive Care Unit in Bahir Dar, Ethiopia: A retrospective follow up study, 2022.

Tefera B, Ahmed A, Yehualashet S PLoS One. 2024; 19(10):e0311890.

PMID: 39436945 PMC: 11495620. DOI: 10.1371/journal.pone.0311890.

Surgical necrotizing enterocolitis risk factors in extremely preterm infants: a Korean nationwide cohort study.

Kim S, Son J, Park H Pediatr Res. 2024; .

PMID: 39181982 DOI: 10.1038/s41390-024-03519-3.

Cerebral Palsy and Motor Impairment After Extreme Prematurity: Prediction of Diagnoses at Ages 2 and 10 Years.

Marinelli T, Yi J, OShea T, Joseph R, Hooper S, Kuban K J Pediatr. 2024; 271:114037.

PMID: 38580191 PMC: 11239312. DOI: 10.1016/j.jpeds.2024.114037.

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