Surgical necrotizing enterocolitis but not spontaneous intestinal perforation is associated with adverse neurological outcome at school age

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • The German Neonatal Network (GNN) - (Author)
  • Department of Paediatrics
  • Center for feto/neonatal Health
  • Universitätsklinikum Schleswig-Holstein - Campus Lübeck
  • Saarland University
  • University of Lübeck
  • Klinikum Aschaffenburg-Alzenau
  • University of Cologne
  • University of Hamburg
  • Medical Center Bethel
  • Heinrich Heine University Düsseldorf
  • Hospital Südstadt Rostock
  • University of Duisburg-Essen
  • Vivantes Klinikum Neukolln
  • Ruhr University Bochum
  • Klinikum Dortmund gGmbH
  • Asklepios Hospital Hamburg-Barmbek
  • Hannover Medical School (MHH)
  • Klinikum Stuttgart
  • Hospital of the Brothers of Mercy Regensburg
  • Saarbrücken General Hospital
  • Leverkusen Hospital
  • Hospital Mönchengladbach
  • Otto von Guericke University Magdeburg
  • Children's Hospital DRK Siegen
  • Diakonissenhospital Flensburg
  • Hospital Itzehoe
  • Witten/Herdecke University
  • Westküstenklinikum Heide
  • TUD Dresden University of Technology
  • University of Münster
  • Nuremberg Clinic
  • Heidelberg University 
  • University of Tübingen
  • Bürgerhospital Frankfurt am Main
  • Helios Hospital Group
  • RWTH Aachen University
  • Christophorus Kliniken Coesfeld
  • GFO Hospitals Bonn
  • Martin Luther University Halle-Wittenberg
  • Klinikum Kassel GmbH
  • Leipzig University
  • Children's Hospital Auf der Bult

Abstract

Gastrointestinal complications during the neonatal period, i.e. necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP), are associated with adverse short-term outcome in very-low-birthweight infants (VLBWI, <1500 g birth weight). However, little is known about the neurological outcome of survivors at school age. We analysed data of 2241 infants followed-up at the age of 6 years. To determine the effect of NEC and SIP on cognitive outcome in consideration of other important confounding factors, we used multivariable logistic regression models. In addition, infants with surgical diagnosis of NEC (n = 43) or SIP (n = 41) were compared to NEC (n = 43) or SIP (n = 41) negative controls using Mahalanobis distance matching. Infants with a history for NEC had a three times increased risk (RR 3.0 [1.8–4.2], p < 0.001) to develop IQ scores <85 while history of surgical SIP did not increase the relative risk for lower IQs at school age (RR 1.0 [0.4–2.1], p = 1.000). In a matched-cohort analysis, we confirmed that infants with surgical NEC had lower mean IQ results than unaffected controls (±SD) (85±17 vs. 94±14, p = 0.023) while no differences were found for history of SIP. Our results reflect that the different aetiology and inflammatory extent of NEC and SIP may lead to disparate neurodevelopment trajectories. Hence, our data suggest a potential role of early gut-brain axis distortion in infants with NEC which needs to be further explored.

Details

Original languageEnglish
Article number2373
JournalScientific reports
Volume10
Issue number1
Publication statusPublished - 1 Dec 2020
Peer-reviewedYes

External IDs

PubMed 32047169

Keywords

ASJC Scopus subject areas