Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants <1000 g

J Perinatol. 2004 Sep;24(9):534-40. doi: 10.1038/


Objective: To determine the growth and neurodevelopmental outcome, as well as predictors of the latter in extremely low-birth-weight (ELBW) infants with definitive necrotizing enterocolitis (NEC).

Study design: Case - control analysis. In all, 17 ELBW infants <1000 g with Stage 2 or 3 NEC were matched to 51 control infants without NEC. Demographics, clinical course, growth, and neurodevelopmental outcome were compared.

Results: Demographic and clinical characteristics of both groups were similar except that NEC infants had more culture-proven sepsis (59 vs 24%, p=0.02), longer intubation (36 vs 16 days, p=0.003) and longer hospital stay (134 vs 86 days, p<0.001). At 18 to 22 months corrected age BSID-II mental scores (MDI) were similar between groups (74+/-14 vs 81+/-13, p=0.2). However, the psychomotor index (PDI) (66+/-18 vs 88+/-14), the proportion with abnormal neurologic examination (54 vs 9%), subnormal height (38 vs 3%) and head circumference (23 vs 0%) were significantly higher in NEC infants (p<0.05). A logistic model identified NEC and chronic lung disease as predictors for abnormal PDI and MDI, respectively.

Conclusions: NEC and its comorbidities are associated with severe neurodevelopmental and growth delay in ELBW infants.

MeSH terms

  • Case-Control Studies
  • Child, Preschool
  • Developmental Disabilities / etiology
  • Enterocolitis, Necrotizing / complications*
  • Female
  • Follow-Up Studies
  • Growth
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature, Diseases / etiology*
  • Infant, Very Low Birth Weight
  • Male
  • Nervous System Diseases / complications*
  • Neurologic Examination
  • Retrospective Studies
  • Risk Factors
  • Sepsis / etiology
  • Time Factors