Intestinal perforation in very low birth weight infants: Growth and neurodevelopment at 1 year of age

被引：45

作者：

Adesanya O.A. ^{[1
]}

O'Shea T.M. ^{[1
]}

Turner C.S. ^{[2
]}

Amoroso R.M. ^{[3
,5
]}

Morgan T.M. ^{[3
,5
]}

Aschner J.L. ^{[4
]}

机构：

[1] Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC

[2] Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, NC

[3] Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC

[4] Department of Pediatrics, Vanderbilt University Medical Center, Nashville

[5] Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC

来源：

Journal of Perinatology | 2005年 / 25卷 / 9期

关键词：

D O I：

10.1038/sj.jp.7211360

中图分类号：

学科分类号：

摘要：

Objective: To compare growth and neurodevelopment in surviving very low birth weight (VLBW) infants with an intestinal perforation (IP) caused by necrotizing enterocolitis (NEC) versus spontaneous intestinal perforation (SIP). Study Design: Retrospective, observational cohort study. Infants born between January 1996 and December 1999 with birth weight < 1500 g and a diagnosis of intestinal perforation were identified and data extracted from NICU, surgical and hospital databases. Results: IP was identified in 62 of 1357 VLBW infants (5%); 39 infants (63%) had surgical NEC and 23 (37%) had SIP. Among survivors, 21/28 with surgical NEC (75%) and 13/18 with SIP (72%) returned for follow-up. At 1-year adjusted age, there were no differences in growth parameters but the Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) were lower in survivors with NEC versus SIP (mean difference in MDI=15; 95% confidence limits=3, 28; p=0.02; mean difference in PDI=14; 95% confidence limits=0.4, 28; p=0.04). Conclusions: Intestinal perforation caused by NEC, as compared to SIP, is associated with worse neurodevelopmental outcome at 1 year. © 2005 Nature Publishing Group. All rights reserved.

引用

页码：583 / 589

页数：6

共 21 条

[1] Kliegmann R.M., Faranoff A.A., Neonatal necrotizing enterocolitis: A nine-year experience, part 1/2, Am J Dis Child, 135, pp. 603-611, (1981)
[2] Aschner J.L., Deluga K.S., Metlay L.A., Emmens R.W., Hendricks-Munoz K.D., Spontaneous focal perforation in very low birth weight infants, J Pediatr, 113, pp. 364-367, (1988)
[3] Meyers C.L., Payne N.R., Roback S.A., Spontaneous isolated intestinal perforation in neonates with birth weight < 1,000 g, not associated with necrotizing enterocolitis, J Pediatr Surg, 26, pp. 714-717, (1991)
[4] Adderson E.E., Pappin A., Pavia A.T., Spontaneous intestinal perforation in premature infants: A distinct clinical entity associated with systemic candidiasis, J Pediatr Surg, 33, pp. 1463-1467, (1998)
[5] Buchheit J.Q., Stewart D.L., Clinical comparison of localized intestinal perforation and necrotizing enterocolitis in neonates, Pediatrics, 93, pp. 32-36, (1994)
[6] Touloukian R.J., Gastric Ischemia: The primary factor in neonatal perforations, Clin Pediatr, 12, pp. 219-225, (1973)
[7] Borzotta A.P., Groff D.B., Gastrointestinal perforation in infants, Am J Surg, 155, pp. 447-452, (1988)
[8] Ladd A.P., Rescorla F.J., West K.W., Scherer III L.R., Engum S.A., Grosfeld J.L., Long-term follow-up after resection for necrotizing enterocolitis: Factors affecting outcome, J Pediatr Surg, 33, pp. 967-972, (1998)
[9] Walsh M.C., Kliegman R.M., Hack M., Severity of necrotizing enterocolitis: Influence on outcome at 2 years of age, Pediatrics, 84, pp. 808-814, (1989)
[10] Vohr B.R., Wright L.L., Dusick A.M., Et al., Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Developmental Neonatal Research Network, 1993-1994, Pediatrics, 105, pp. 1216-1226, (2000)

← 1 2 3 →