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Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants.
Speer, Allison L; Lally, Kevin P; Pedroza, Claudia; Zhang, Yuxin; Poindexter, Brenda B; Chwals, Walter J; Hintz, Susan R; Besner, Gail E; Stevenson, David K; Ohls, Robin K; Truog, William E; Stoll, Barbara J; Rysavy, Matthew A; Das, Abhik; Tyson, Jon E; Blakely, Martin L.
Afiliación
  • Speer AL; Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
  • Lally KP; Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
  • Pedroza C; Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
  • Zhang Y; Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
  • Poindexter BB; Department of Pediatrics, Division of Neonatology, Emory University School of Medicine, Atlanta, GA.
  • Chwals WJ; Department of Pediatric Surgery, Floating Hospital for Children, Tufts Medical Center, Boston, MA.
  • Hintz SR; Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
  • Besner GE; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH.
  • Stevenson DK; Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
  • Ohls RK; University of New Mexico Health Sciences Center, Albuquerque, NM.
  • Truog WE; Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT.
  • Stoll BJ; Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO.
  • Rysavy MA; Department of Pediatrics, Division of Neonatology, Emory University School of Medicine, Atlanta, GA.
  • Das A; Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
  • Tyson JE; Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD.
  • Blakely ML; Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
Ann Surg ; 280(3): 432-443, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-39264354
ABSTRACT

OBJECTIVE:

We aimed to determine the incidence of growth failure in infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) and whether initial laparotomy versus peritoneal drainage (PD) impacted the likelihood of growth failure. SUMMARY BACKGROUND DATA Infants with surgical NEC and SIP have high mortality, and most have neurodevelopmental impairment and poor growth. Existing literature on growth outcomes for these infants is limited.

METHODS:

This is a preplanned secondary study of the Necrotizing Enterocolitis Surgery Trial dataset. The primary outcome was growth failure (Z-score for weight <-2.0) at 18 to 22 months. We used logistic regression, including diagnosis and treatment, as covariates. Secondary outcomes were analyzed using the Fisher exact or Pearson χ2 test for categorical variables and the Wilcoxon rank sum test or one-way ANOVA for continuous variables.

RESULTS:

Among 217 survivors, 207 infants (95%) had primary outcome data. Growth failure at 18 to 22 months occurred in 24/50 (48%) of NEC infants versus 65/157 (42%) SIP (P=0.4). The mean weight-for-age Z-score at 18 to 22 months in NEC infants was -2.05±0.99 versus -1.84±1.09 SIP (P=0.2), and the predicted mean weight-for-age Z-score SIP (Beta -0.27; 95% CI -0.53, -0.01; P=0.041). Median declines in weight-for-age Z-score between birth and 18 to 22 months were significant in all infants but most severe (>2) in NEC infants (P=0.2).

CONCLUSIONS:

This first ever prospective study of growth outcomes in infants with surgical NEC or SIP demonstrates that growth failure is very common, especially in infants with NEC, and persists at 18-22 months.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enterocolitis Necrotizante / Perforación Intestinal Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enterocolitis Necrotizante / Perforación Intestinal Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos