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Growth outcome trends after necrotizing enterocolitis in preterm infants across changes in nutritional practices

Lan-Wan Wang1,2,3, Chi-Hsiang Chu4, Yung-Chieh Lin5

  • 1Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.

Pediatric Research
|December 17, 2025
PubMed

Insights

Extremely preterm infants with stage-II necrotizing enterocolitis (NEC) achieved catch-up growth. However, those with stage-III NEC showed persistent head growth deficits despite improved nutrition.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Investigating growth outcomes in extremely preterm infants with necrotizing enterocolitis (NEC) is crucial.
  • Understanding the impact of evolving nutritional practices on these vulnerable infants is essential.

Purpose of the Study:

  • To analyze trends in postnatal and post-discharge growth in extremely preterm infants with NEC.
  • To assess how changes in nutritional practices over time affect growth outcomes based on NEC severity.

Main Methods:

  • A multicenter cohort study included 3046 infants born before 28 weeks' gestation (2006-2019).
  • Growth trajectories (zBW, zHC) were analyzed from NICU discharge to 24 months corrected age.
  • Propensity-score-matching (PSM) was used to compare infants across NEC severity (no/stage-I, stage-II, stage-III) and three epochs (2006-2019).

Main Results:

  • Infants with stage-II/III NEC had lower zBW and zHC at discharge in later epochs.
  • Stage-II NEC infants achieved comparable weight and head growth by 6-24 months.
  • Stage-III NEC infants showed weight catch-up by 12-24 months but persistent head growth deficits.

Conclusions:

  • Infants with stage-II NEC demonstrate catch-up growth, indicating positive responses to nutritional advancements.
  • Stage-III NEC consistently presents challenges, with persistent head growth deficits observed up to 24 months.
  • Nutritional practices have improved outcomes, but specific interventions may be needed for severe NEC to optimize neurodevelopmental trajectories.
Abstract

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