Surgical NEC-associated cerebellar underdevelopment and PDA: Call for close monitoring and action

Necrotizing enterocolitis (NEC) is a systemic inflammatory disease of very low birth weight infants and is associated with brain injury and poor neurodevelopmental outcomes. The cerebellar injury is seen in one third of cases with surgical cases. The association between patent ductus arteriosus (PDA) and necrotizing enterocolitis, cerebral and gut hemodynamics in preterm infants is well documented. The cerebellum is at the high risk of underdevelopment and injury in preterm infants with surgical NEC and PDA. The combined exposure of NEC and PDA most likely affect the normal cerebellar development further due to inflammatory and hypoperfusion insults. There is a need to develop the targeted monitoring and therapeutic approach for cerebellum in preterm infants with surgical NEC and PDA.