Document Detail

Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis.
MedLine Citation:
PMID:  16984980     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: (1) To characterise neurodevelopmental outcome of neonates with necrotizing enterocolitis (NEC); (2) to define whether NEC increases risk of neurodevelopmental impairment in very low birth weight neonates; (3) to investigate whether stage of disease or need for surgery increase risk of poor outcome. DESIGN: A systematic review was performed. Searches identified 182 relevant papers. Ten studies compared extremely low birthweight neonates with NEC to infants of similar age and gestation who did not develop NEC. Data are reported as OR (95% CIs, p values for test for overall effect) and compared by chi2. RESULTS: 7843 children (821 with NEC) were included in the meta-analysis. Median follow-up was 20 months (range 12 to 156). Overall, 45% of children who had neonatal NEC were neurodevelopmentally impaired. Infants with NEC were significantly more likely than infants of similar age and gestation who did not develop NEC to be neurodevelopmentally impaired (1.6 (1.3 to 2.0), p = 0.0001) including a higher risk of cerebral palsy (1.5 (1.2 to 2.0), p = 0.001), visual (2.3 (1.0 to 5.1), p = 0.04), cognitive (1.7 (1.4 to 2.2), p<0.0001) and psychomotor impairment (1.7 (1.3 to 2.2), p<0.0001). The odds ratio of neurodevelopmental impairment was also 2.3 times higher in neonates with Bell's stage III disease or requiring surgery ((1.5 to 3.6), p = 0.0001). CONCLUSIONS: NEC is associated with significantly worse neurodevelopmental outcome than prematurity alone. Presence of advanced NEC and need for surgery increase the risk of neurological impairment.
Clare M Rees; Agostino Pierro; Simon Eaton
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2006-09-19
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  92     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-23     Completed Date:  2007-05-22     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F193-8     Citation Subset:  AIM; IM    
Department of Paediatric Surgery, Institute of Child Health, London, UK.
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MeSH Terms
Cognition Disorders / etiology
Developmental Disabilities / etiology*
Enterocolitis, Necrotizing / complications,  therapy*
Infant, Newborn
Infant, Very Low Birth Weight*
Nervous System Diseases / etiology*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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