Long-term growth outcomes in neonates diagnosed with necrotizing enterocolitis: a 20-year analysis

Malek, Adil J.; Mrdutt, Mary M.; Scrushy, Marinda G.; Mallet, Lea H.; Shaver, Courtney; Sanders, Emily; Stagg, Hayden W.; Perger, Lena

doi:10.1016/j.jpedsurg.2019.01.028

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…Malek et al investigated long-term, up to 20 years, growth outcomes in children born preterm with and without NEC, and they showed that, as in our study, children with NEC had lower weight gain during the follow-up period than children without NEC. 12 Malek et al suggest further that there are variations in intestinal physiology among NEC survivors and not only the intestinal length after surgery that affect growth. Soraisham et al found, in contrast to our study, no significant difference in either weight or height at 3 years of age among NEC cases compared to matched controls.…”

Section: Discussionmentioning

confidence: 99%

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Body composition and bone mass among 5-year-old survivors of necrotizing enterocolitis

Magnusson

Swolin-Eide²,

Elfvin³

2022

Pediatr Res

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Background Necrotizing enterocolitis (NEC) affects the intestine of preterm infants. Preterm infants risk inadequate bone mineralization. This risk may increase if the intestinal uptake of minerals is affected after NEC. Methods This is a study of growth, bone mineral density (BMD), bone mineral content (BMC), and body composition at 5 years of age among Swedish children born before gestational week 37 + 0 with a history of NEC, minimum stage IIA, compared to matched controls. Fifty children, 25 NEC cases and 25 controls, were examined with dual energy X-ray absorptiometry (DXA) and DXA with laser. Results The NEC cases had lower weight, −1.3 SDS vs −0.7 SDS, a lower fat mass and fat percent, 23.4 vs 29.1%, compared to the controls. NEC cases had lower BMC total body head excluded, 355.6 g vs 416.7 g. BMD Z-scores were lower among NEC cases in total body head excluded, −0.7 vs −0.1, and in lumbar spine. Conclusions Preterm NEC survivors at 5 years of age had reduced growth, an altered body composition, and indications of a lower bone mass compared to matched controls. The study suggests that preterm infants diagnosed with NEC need special attention during childhood regarding growth and bone health. Impact A follow-up longitudinal study of growth, bone health, and body composition at 5 years of age among children born preterm with a history of NEC compared to matched controls. The NEC cases had lower weight than controls. NEC cases had an altered body composition with lower fat mass compared to controls. The DXA results showed that the NEC cases had lower bone mineral content and a tendency to lower bone mineral density. The study suggests that preterm infants diagnosed with NEC need special attention at follow-up regarding growth and bone health compared to preterm infants without NEC.

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Section: Discussionmentioning

confidence: 99%

“… 10 , 11 Others however have shown that children and adolescents with a history of NEC have a slower growth rate compared to controls without NEC. 12 …”

Section: Introductionmentioning

confidence: 99%

Body composition and bone mass among 5-year-old survivors of necrotizing enterocolitis

Magnusson

Swolin-Eide²,

Elfvin³

2022

Pediatr Res

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“…Other factors that may contribute to growth retardation in BPD include intrauterine growth restriction, which is a risk factor for BPD, and NEC 30,31 . A history of NEC is associated with slower growth rates and growth delay 32,33 . Treatment of NEC can require bowel resection, potentially leading to short gut syndrome or other problems of gastrointestinal absorption.…”

Section: Pathophysiologymentioning

confidence: 99%

Nutrition and growth in infants with established bronchopulmonary dysplasia

Bauer

Vanderpool

Ren

et al. 2021

Pediatric Pulmonology

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Bronchopulmonary dysplasia (BPD) remains the most common late morbidity of preterm birth. Ongoing clinical care and research have largely focused on the pathogenesis and prevention of BPD in preterm infants. However, preterm infants who develop BPD have significant medical needs that persist throughout their neonatal intensive care unit course and continue post‐discharge, including those associated with growth and nutrition. The objective of this manuscript was to provide a review on nutrition and growth in infants with established BPD after discharge from the hospital and to identify the knowledge and research gaps to provide direction for future studies.

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“…[5][6][7] Despite these advances in neonatal intensive care, NEC remains a common cause of surgical intervention, long-term morbidity and mortality in preterm and VLBW neonates. [8][9][10][11][12][13][14][15] Understanding the natural history of NEC is essential to the development of novel interventions to prevent the disease or improve outcomes in affected neonates. Natural history studies can illustrate how patient characteristics, biomarkers and care processes influence disease onset, progression, and resolution, and can frame this information in a relevant, contemporary context.…”

Section: Introductionmentioning

confidence: 99%

“…5 6 7 Despite these advances in neonatal intensive care, NEC remains a common cause of surgical intervention, long-term morbidity, and mortality in preterm and VLBW neonates. 8 9 10 11 12 13 14 15…”

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confidence: 99%

Necrotizing Enterocolitis in Very Low Birth Weight Neonates: A Natural History Study

2022

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Objective – We characterize the most recent natural history of necrotizing enterocolitis (NEC), as this is an essential first step in guiding the prevention and treatment of this disease in the present day. Study Design – We performed a retrospective cohort study of neonates who were born at 23-29 weeks gestation and birth weight <1500 grams who received care from the Pediatrix Medical Group between 2004 and 2019. We assessed the incidence of medical and surgical NEC and the patterns of initial antibiotic treatment to develop a contemporary cohort for further analysis. Among patients discharged between 2015 and 2019 we characterized the stage-specific risk factors for patients diagnosed with medical or surgical NEC, as well as patterns of disease onset, progression, biomarkers and outcomes. We used the same approach to characterize patients diagnosed with suspected NEC. Results – Among 34032 patients in the contemporary cohort, 1150 (3.4%) were diagnosed with medical NEC and 543 (1.6%) were diagnosed with surgical NEC. The temporal pattern of disease onset was different for medical and surgical NEC, with gestational age- and birth weight-specific risk disparities emerging earlier in surgical NEC. Thirty-day mortality was much greater among surgical NEC patients (medical NEC 16.4% vs. surgical NEC 43.0%), as were rates of various in-hospital and long-term outcomes. Suspected NEC was diagnosed in 1256 (3.7%) patients, among whom risk factors and disease onset, progression, and outcomes closely resembled those of medical NEC. Conclusion – Analyzing data from a contemporary cohort enabled us to characterize the current, stage-specific natural history of NEC, including novel insights into suspected NEC. Future studies could leverage this cohort to characterize how specific patient characteristics, care processes or biomarkers may influence or predict disease outcomes.

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Long-term growth outcomes in neonates diagnosed with necrotizing enterocolitis: a 20-year analysis

Cited by 5 publications

References 16 publications

Body composition and bone mass among 5-year-old survivors of necrotizing enterocolitis

Body composition and bone mass among 5-year-old survivors of necrotizing enterocolitis

Nutrition and growth in infants with established bronchopulmonary dysplasia

Necrotizing Enterocolitis in Very Low Birth Weight Neonates: A Natural History Study

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