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Intestinal perforation in very low birth weight infants: growth and neurodevelopment at 1 year of age

Olubukunola A Adesanya1, T Michael O'Shea, Charles S Turner

  • 1Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|July 22, 2005
PubMed

Insights

Very low birth weight infants with intestinal perforation due to necrotizing enterocolitis showed poorer neurodevelopmental outcomes compared to those with spontaneous intestinal perforation. Growth parameters were similar at one year.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Developmental Pediatrics

Background:

  • Intestinal perforation (IP) is a serious complication in very low birth weight (VLBW) infants.
  • Distinguishing between IP caused by necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) is crucial for understanding outcomes.

Purpose of the Study:

  • To compare the growth and neurodevelopmental outcomes of surviving VLBW infants with IP secondary to NEC versus SIP.
  • To identify potential differences in long-term neurodevelopmental trajectories based on the etiology of intestinal perforation.

Main Methods:

  • Retrospective, observational cohort study design.
  • Inclusion of VLBW infants (<1500 g) diagnosed with intestinal perforation between 1996 and 1999.
  • Data extraction from NICU, surgical, and hospital databases for analysis.

Main Results:

  • IP occurred in 5% of VLBW infants, with 63% attributed to NEC and 37% to SIP.
  • Among survivors with follow-up, no significant differences in growth parameters were observed at 1-year adjusted age.
  • Infants with NEC-related IP demonstrated significantly lower Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) scores compared to those with SIP.

Conclusions:

  • Intestinal perforation caused by NEC is associated with significantly worse neurodevelopmental outcomes at one year of age compared to spontaneous intestinal perforation in VLBW infants.
  • These findings highlight the importance of considering the etiology of intestinal perforation when assessing neurodevelopmental risks in premature infants.
Abstract

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