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Long-term impact of necrotizing enterocolitis on somatosensory function in preterm born children
Judith A Ten Barge1, Marijn J Vermeulen2, Claudia M G Keyzer-Dekker3
1Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. j.tenbarge@erasmusmc.nl.
Insights
Children with a history of necrotizing enterocolitis (NEC) show reduced cold pain sensitivity. However, their overall sensory processing and reported outcomes are similar to other preterm infants, highlighting the lasting impact of NEC on pain perception.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pain Research
Background:
- Necrotizing enterocolitis (NEC) is a severe intestinal disease in preterm infants, often requiring significant pain management.
- Pain and analgesics during critical neurodevelopment may affect sensory system development.
- Understanding long-term sensory outcomes in NEC survivors is crucial.
Purpose of the Study:
- To compare somatosensory function and sensory processing in preterm children with and without a history of NEC.
- To assess self- and parent-reported outcomes, including behavior and quality of life.
- To investigate the lasting effects of NEC and its treatment on neurodevelopment.
Main Methods:
- A cross-sectional cohort study matched preterm children (6-15 years) with and without NEC history.
- Quantitative sensory testing was performed in a mobile research lab at home.
- Parents completed validated questionnaires on sensory processing, behavior, executive function, pain, and quality of life.
Main Results:
- Children with NEC history had significantly lower cold pain thresholds compared to controls.
- Executive function was poorer in the NEC group, though not statistically significant after confounder correction.
- No significant differences were observed in sensory processing, behavioral issues, chronic pain, or quality of life.
Conclusions:
- Preterm children with a history of NEC exhibit altered cold pain sensitivity.
- Somatosensory function and sensory processing are generally similar between NEC survivors and controls.
- Most self- and parent-reported outcomes do not differ significantly, suggesting resilience in other domains.
Background:
Necrotizing enterocolitis (NEC) is a painful intestinal disease in preterm infants that causes severe prolonged pain requiring high amounts of analgesics. In a critical stage of neurodevelopment, pain and analgesics potentially impact sensory development. This study compared somatosensory function and sensory processing in preterm-born children with and without a history of NEC, as well as key self-/parent-reported outcomes.
Methods:
In this cross-sectional cohort study, preterm-born children (6-15 years old) with NEC were matched with controls. Each child underwent quantitative sensory testing in a mobile research lab at home. Parents completed questionnaires on their child's sensory processing, behavior, executive function, chronic pain, and (health-related) quality of life.
Results:
Sixty-six children (22 NEC, 44 control) participated. Children with a history of NEC exhibited lower cold pain thresholds (β = -11 °C, 95% CI [-21;-1.0], p = 0.03) compared to those without NEC. Moreover, they exhibited poorer executive function, though no longer significant after correcting for confounders. No significant differences were found in sensory processing, behavioral problems, chronic pain, and (health-related) quality of life.
Conclusion:
Children with a history of NEC are less sensitive to cold pain, but have otherwise similar somatosensory function and sensory processing to other preterm-born children. Most self- and parent-reported outcomes are comparable to those of other preterm-born children without NEC.
Impact:
Necrotizing enterocolitis in preterm infants lastingly alters their (cold) pain sensitivity. Most self- and parent-reported outcomes of children with a history of NEC are similar to those of other preterm-born children. Sensory processing and behavioral problems are common among both preterm-born children with and without NEC history. Our results warrant the search for protective strategies during NICU admission and thorough follow-up after NICU discharge.
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