Association between neurodevelopmental outcomes and concomitant presence of NEC and IVH in extremely low birth weight infants

• Published in: Journal of perinatology Vol. 44; no. 1; pp. 108 - 115
• Main Authors: Culbreath, Katherine, Keefe, Gregory, Nes, Emily, Edwards, Erika M., Knell, Jamie, Morrow, Kate A., Soll, Roger F., Jaksic, Tom, Horbar, Jeffrey D., Modi, Biren P.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.01.2024; Nature Publishing Group
• Subjects: 692/308/409; 692/700/1750; Birth Weight; Bowel disease; Cerebral Hemorrhage - complications; Child development; Developmental disabilities; Enterocolitis; Enterocolitis, Necrotizing - complications; Enterocolitis, Necrotizing - epidemiology; Enterocolitis, Necrotizing - surgery; Hemorrhage; Humans; Infant; Infant, Extremely Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases - epidemiology; Infants; Low birth weight; Medicine; Medicine & Public Health; Necrosis; Necrotizing enterocolitis; Neurodevelopment; Neurology; Pediatric Surgery; Pediatrics; Premature babies; Prognosis; Risk
• ISSN: 0743-8346; 1476-5543; 1476-5543
• DOI: 10.1038/s41372-023-01780-8

Objective To quantify the association between necrotizing enterocolitis (NEC) and neurodevelopmental disability (NDI) in extremely low birth weight (ELBW) infants with intraventricular hemorrhage (IVH). Study design ELBW survivors born 2011–2017 and evaluated at 16–26 months corrected age in the Vermont Oxford Network (VON) ELBW Follow-Up Project were included. Logistic regression determined the adjusted relative risk (aRR) of severe NDI in medical or surgical NEC compared to no NEC, stratified by severity of IVH. Results Follow-up evaluation occurred in 5870 ELBW survivors. Compared to no NEC, medical NEC had no impact on NDI, regardless of IVH status. Surgical NEC increased risk of NDI in patients with no IVH (aRR 1.69; 95% CI 1.36–2.09), mild IVH (aRR 1.36;0.97–1.92), and severe IVH (aRR 1.35;1.13–1.60). Conclusions ELBW infants with surgical NEC carry increased risk of neurodevelopmental disability within each IVH severity stratum. These data describe the additive insult of surgical NEC and IVH on neurodevelopment, informing prognostic discussions and highlighting the need for preventative interventions.