561 NECROTIZING ENTEROCOLITIS (NEC) IN THE VLBW: AN ENCOURAGING FOLLOW-UP REPORT

Abstract

To evaluate the long term growth and development of VLBW(<1.5 Kg)infants with NEC, we prospectively followed all those surviving NEC from 1975 to 1978. Out of 551 VLBW admissions, 48(5.5%) developed NEC confirmed radiologically or at surgery. 23(48%)survived. 2 were lost to follow-up and 1 died after discharge. The remaining 20 infants(mean BW 1.2Kg, range.8-1.4Kg,GA 30 wks, range 27-32wks)were followed to a mean of 28 mos and compared to 330 surviving infants without NEC(non-NEC) of similar birth wt.

The course of NEC included perforation requiring surgery in 20, of whom 11 required an ileostomy. Only 4/20 were SGA(<3%) at birth but by discharge 17/20(85%)weighed less than the 3% for age. During infancy 16/20 were rehospitalized. 12 for reasons related to NEC. 6 infants had failure to thrive due to short bowel syndrome or secretory diarrhea which resolved with parenteral nutrition and ileostomy closure.

Despite the high mortality and severe morbidity during infancy, most survivors of NEC subsequently progress well and function at the same level as infants without NEC.

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