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Shah TA, Meinzen-Derr J, Gratton T, Steichen J, Donovan EF, Yolton K, Alexander B, Narendran V, Schibler KR. Hospital and neurodevelopmental outcomes of extremely low-birth-weight infants with necrotizing enterocolitis and spontaneous intestinal perforation. J Perinatol 2012; 32:552-8. [PMID: 22157625 PMCID: PMC3496418 DOI: 10.1038/jp.2011.176] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We sought to determine the incidence of necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) in surviving extremely low-birth-weight (ELBW, <1000 g birth weight) infants and to establish the impact of NEC on outcomes by hospital discharge and at 18 to 22 months adjusted age in a large, contemporary, population-based practice. STUDY DESIGN Hospital outcome data for all ELBW infants born in the greater Cincinnati region from 1998 to 2009 were extracted from the National Institute of Child Health Neonatal Research Network Database. Neurodevelopmental outcome at 18 to 22 months was assessed using Bayley Scales of Infant Development-II scores for Mental Developmental Index and Psychomotor Developmental Index. Multivariable logistic regression was used and adjusted odds ratios reported to control for confounders. RESULT From 1998 to 2009, ELBW infants accounted for 0.5% of the 352 176 live-born infants in greater Cincinnati. The incidence of NEC was 12%, with a 50% case-fatality rate. Death before discharge, morbid complications of prematurity and neurodevelopmental impairment were all increased among infants diagnosed with NEC. Infants with surgical NEC and SIP had a higher incidence of death, but long-term neurodevelopmental outcomes were not different comparing surviving ELBW infants with medical NEC, surgical NEC and SIP. CONCLUSION Although ELBW infants comprise a very small proportion of live-born infants, those who develop NEC and SIP are at an increased risk for death, morbid complications of prematurity and neurodevelopmental impairment. No significant differences in neurodevelopmental outcomes were observed between the medical and surgical NEC and SIP groups.
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Affiliation(s)
- TA Shah
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - J Meinzen-Derr
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - T Gratton
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - J Steichen
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - EF Donovan
- Department of Pediatrics, Child Policy Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - K Yolton
- Department of Pediatrics, General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - B Alexander
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - V Narendran
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - KR Schibler
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Little BB, Spalding S, Walsh B, Keyes DC, Wainer J, Pickens S, Royster M, Villanacci J, Gratton T. Blood lead levels and growth status among African–American and Hispanic children in Dallas, Texas – 1980 and 2002: Dallas Lead Project II. Ann Hum Biol 2009; 36:331-41. [DOI: 10.1080/03014460902806615] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- B. B. Little
- Departments of Mathematics, and of Physics and Engineering, Texas Data Mining Research Institute, and Division of Academic Affairs, Tarleton State University, Stephenville, Texas
- Parkland Health & Hospital System, Dallas, Texas
| | - S. Spalding
- Parkland Health & Hospital System, Dallas, Texas
| | - B. Walsh
- Parkland Health & Hospital System, Dallas, Texas
| | - D. C. Keyes
- John Peter Smith Health Network, Fort Worth, Texas
| | - J. Wainer
- Parkland Health & Hospital System, Dallas, Texas
| | - S. Pickens
- Parkland Health & Hospital System, Dallas, Texas
| | - M. Royster
- Parkland Health & Hospital System, Dallas, Texas
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