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Influence of surgical intervention on neurodevelopmental outcome in infants with focal intestinal perforation

Yujiro Tanaka1, Hiroo Uchida1,2, Hiroshi Kawashima1

  • 1Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|February 14, 2015
PubMed

Insights

Focal intestinal perforation (FIP) in very low-birthweight infants did not significantly impact neurodevelopmental outcomes compared to infants without surgical conditions. However, premature infants born before 26 weeks gestation with FIP showed poorer outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Developmental Pediatrics

Background:

  • Intestinal perforation, a serious condition in very low-birthweight (VLBW) infants, includes necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP).
  • While FIP survivors generally show better outcomes than NEC patients, their neurodevelopmental outcomes compared to infants without surgical conditions remain less understood.

Purpose of the Study:

  • To compare the neurodevelopmental outcomes of very low-birthweight infants who survived focal intestinal perforation (FIP) with those of infants who did not require surgery.

Main Methods:

  • A retrospective analysis compared eight VLBW infants with FIP to 24 matched controls without surgical diseases.
  • Neurodevelopmental outcomes were assessed using the Kyoto Scale of Psychological Development.
  • Infants with sepsis or severe intraventricular hemorrhage (IVH) were excluded to isolate FIP's impact.

Main Results:

  • At 18 months to 3 years corrected age, 37.5% of FIP survivors and 50% of controls had normal neurodevelopmental outcomes (P=0.69).
  • All FIP survivors with normal outcomes were born at or after 26 weeks of gestation.

Conclusions:

  • After excluding confounding factors like sepsis and severe IVH, FIP survivors showed no significant difference in neurodevelopmental outcomes compared to infants without surgical diseases.
  • Gestational age appears critical; no FIP infants born before 26 weeks achieved normal neurodevelopment, suggesting prematurity exacerbates FIP's impact.
Abstract

Keywords:
intestinal perforationintraventricular hemorrhageneurodevelopmentsurgeryvery low-birthweight infant

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