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Neurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis.

CPQCC Publication
TitleNeurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis.
Publication TypeJournal Article
Year of Publication2014
AuthorsWadhawan R, Oh W, Hintz SR, Blakely ML, Das A, Bell EF, Saha S, Laptook AR, Shankaran S, Stoll BJ, Walsh MC, Higgins RD
Corporate AuthorsNICHD Neonatal Research Network
JournalJ Perinatol
Volume34
Issue1
Pagination64-70
Date Published2014 Jan
ISSN1476-5543
KeywordsChild Development, Developmental Disabilities, Enterocolitis, Necrotizing, Female, Follow-Up Studies, Humans, Infant, Infant, Extremely Low Birth Weight, Infant, Newborn, Intestinal Perforation, Logistic Models, Pregnancy, Retrospective Studies, Socioeconomic Factors, Steroids, Young Adult
Abstract

OBJECTIVE: To determine if extremely low birth weight infants with surgical necrotizing enterocolitis have a higher risk of death or neurodevelopmental impairment and neurodevelopmental impairment among survivors (secondary outcome) at 18-22 months corrected age compared with infants with spontaneous intestinal perforation and infants without necrotizing enterocolitis or spontaneous intestinal perforation.

STUDY DESIGN: Retrospective analysis of the Neonatal Research Network very low birth weight registry, evaluating extremely low birth weight infants born between 2000 and 2005. The study infants were designated into three groups: (1) spontaneous intestinal perforation without necrotizing enterocolitis; (2) surgical necrotizing enterocolitis (Bell's stage III); and (3) neither spontaneous intestinal perforation nor necrotizing enterocolitis. Multivariate logistic regression analysis was performed to evaluate the association between the clinical group and death or neurodevelopmental impairment, controlling for multiple confounding factors including center.

RESULT: Infants with surgical necrotizing enterocolitis had the highest rate of death before hospital discharge (53.5%) and death or neurodevelopmental impairment (82.3%) compared with infants in the spontaneous intestinal perforation group (39.1 and 79.3%) and no necrotizing enterocolitis/no spontaneous intestinal perforation group (22.1 and 53.3%; P<0.001). Similar results were observed for neurodevelopmental impairment among survivors. On logistic regression analysis, both spontaneous intestinal perforation and surgical necrotizing enterocolitis were associated with increased risk of death or neurodevelopmental impairment (adjusted odds ratio 2.21, 95% confidence interval (CI): 1.5, 3.2 and adjusted OR 2.11, 95% CI: 1.5, 2.9, respectively) and neurodevelopmental impairment among survivors (adjusted OR 2.17, 95% CI: 1.4, 3.2 and adjusted OR 1.70, 95% CI: 1.2, 2.4, respectively).

CONCLUSION: Spontaneous intestinal perforation and surgical necrotizing enterocolitis are associated with a similar increase in the risk of death or neurodevelopmental impairment and neurodevelopmental impairment among extremely low birth weight survivors at 18-22 months corrected age.

DOI10.1038/jp.2013.128
Alternate JournalJ Perinatol
PubMed ID24135709
PubMed Central IDPMC3877158
Grant ListU10 HD27851 / HD / NICHD NIH HHS / United States
U10 HD021385 / HD / NICHD NIH HHS / United States
U10 HD40492 / HD / NICHD NIH HHS / United States
U10 HD021364 / HD / NICHD NIH HHS / United States
M01 RR633 / RR / NCRR NIH HHS / United States
U10 HD027871 / HD / NICHD NIH HHS / United States
(U10 HD27871 / HD / NICHD NIH HHS / United States
M01 RR16587 / RR / NCRR NIH HHS / United States
UG1 HD027851 / HD / NICHD NIH HHS / United States
U10 HD027856 / HD / NICHD NIH HHS / United States
U10 HD40689 / HD / NICHD NIH HHS / United States
U10 HD021373 / HD / NICHD NIH HHS / United States
UL1 RR024139 / RR / NCRR NIH HHS / United States
M01 RR6022 / RR / NCRR NIH HHS / United States
U10 HD21364 / HD / NICHD NIH HHS / United States
U10 HD34216 / HD / NICHD NIH HHS / United States
U10 HD027880 / HD / NICHD NIH HHS / United States
U10 HD36790 / HD / NICHD NIH HHS / United States
U10 HD040521 / HD / NICHD NIH HHS / United States
U10 HD021415 / HD / NICHD NIH HHS / United States
U10 HD053109 / HD / NICHD NIH HHS / United States
UG1 HD087229 / HD / NICHD NIH HHS / United States
U10 HD40521 / HD / NICHD NIH HHS / United States
U10 HD27880 / HD / NICHD NIH HHS / United States
M01 RR008084 / RR / NCRR NIH HHS / United States
UG1 HD053089 / HD / NICHD NIH HHS / United States
U10 HD27904 / HD / NICHD NIH HHS / United States
M01 RR125 / RR / NCRR NIH HHS / United States
UL1 TR001449 / TR / NCATS NIH HHS / United States
U10 HD040461 / HD / NICHD NIH HHS / United States
U10 HD40498 / HD / NICHD NIH HHS / United States
U10 HD53089 / HD / NICHD NIH HHS / United States
M01 RR000044 / RR / NCRR NIH HHS / United States
M01 RR016587 / RR / NCRR NIH HHS / United States
M01 RR7122 / RR / NCRR NIH HHS / United States
U10 HD040689 / HD / NICHD NIH HHS / United States
U10 HD040492 / HD / NICHD NIH HHS / United States
U10 HD027853 / HD / NICHD NIH HHS / United States
U10 HD027904 / HD / NICHD NIH HHS / United States
U10 HD021397 / HD / NICHD NIH HHS / United States
U10 HD27856 / HD / NICHD NIH HHS / United States
U10 HD27853 / HD / NICHD NIH HHS / United States
UL1 TR000439 / TR / NCATS NIH HHS / United States
U10 HD40461 / HD / NICHD NIH HHS / United States
UG1 HD034216 / HD / NICHD NIH HHS / United States
M01 RR007122 / RR / NCRR NIH HHS / United States
U10 HD027851 / HD / NICHD NIH HHS / United States
U10 HD21397 / HD / NICHD NIH HHS / United States
M01 RR000997 / RR / NCRR NIH HHS / United States
M01 RR8084 / RR / NCRR NIH HHS / United States
U10 HD21415 / HD / NICHD NIH HHS / United States
M01 RR997 / RR / NCRR NIH HHS / United States
U10 HD21373 / HD / NICHD NIH HHS / United States
UG1 HD053109 / HD / NICHD NIH HHS / United States
M01 RR750 / RR / NCRR NIH HHS / United States
M01 RR000070 / RR / NCRR NIH HHS / United States
U10 HD21385 / HD / NICHD NIH HHS / United States
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UL1 RR24139 / RR / NCRR NIH HHS / United States
U10 HD040498 / HD / NICHD NIH HHS / United States
UG1 HD068278 / HD / NICHD NIH HHS / United States
M01 RR000125 / RR / NCRR NIH HHS / United States
M01 RR006022 / RR / NCRR NIH HHS / United States
U10 HD053089 / HD / NICHD NIH HHS / United States