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Delay in achieving enteral autonomy and growth outcomes in very low birth weight infants with surgical necrotizing enterocolitis

Journal of Perinatology volume 41, pages 150–156 (2021)Cite this article

Subjects

Abstract

Objective

To understand the nutritional intake and growth outcomes of very low birth weight infants with surgical necrotizing enterocolitis (NEC).

Study design

In a retrospective cohort study, linear mixed models were used to compare growth outcomes from birth to 24 months corrected age for very low birth weight (VLBW) infants with surgical NEC to those with spontaneous intestinal perforation (SIP). Kaplan-Meier curves were developed to demonstrate the duration of parenteral nutrition (PN) use.

Result

Height differed by surgical NEC and SIP over time (interaction p = 0.03). Surviving infants with surgical NEC had lower head circumference z-scores at 24 months. Of infants surviving surgical NEC, 71% received PN for >60 days after diagnosis.

Conclusion

The majority of infants with surgical NEC have a delay in achieving enteral autonomy. There was a difference in linear catch-up growth over time between infants with SIP and surgical NEC at 24 months.

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Fig. 1: Flow diagram of study subject selection.
Fig. 2: Duration of parenteral nutrition exposure after diagnosis of necrotizing enterocolitis or spontaneous intestinal perforation.
Fig. 3: Change in weight z-scores in very low birth weight infants with surgical necrotizing enterocolitis or spontaneous intestinal perforation from birth through hospital discharge and follow up at 24 months corrected age.
Fig. 4: Change in height z-scores in very low birth weight infants with surgical necrotizing enterocolitis or spontaneous intestinal perforation from birth through hospital discharge and follow up at 24 months corrected age.
Fig. 5: Change in head circumference z-scores in very low birth weight infants with surgical necrotizing enterocolitis or spontaneous intestinal perforation from birth through hospital discharge and follow up at 24 months corrected age.

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Acknowledgements

This project was supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number 5UL1TR001425-03. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Kera McNelis & Brenda Poindexter

  2. University of Cincinnati, College of Medicine, Cincinnati, OH, USA

    Kera McNelis, Anne Poindexter & Michael Helmrath

  3. Division of Pediatric and General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Gillian Goddard, Todd Jenkins, Anne Poindexter, Jacqueline Wessel & Michael Helmrath

  4. Department of Surgery, Boston Medical Center, Boston, MA, USA

    Gillian Goddard

  5. Department of Pediatrics, Emory University, Atlanta, GA, USA

    Brenda Poindexter

Authors
  1. Kera McNelis
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  2. Gillian Goddard
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  4. Anne Poindexter
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  5. Jacqueline Wessel
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  6. Michael Helmrath
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  7. Brenda Poindexter
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Contributions

KM designed the study, acquired, analyzed and interpreted the data, and drafted the manuscript; GG acquired and analyzed the data, and helped to write the manuscript; TJ analyzed and interpreted the data and critically revised the manuscript; AP acquired the data and critically revised the manuscript; JW, MH, and BP interpreted the data and critically revised the manuscript. All authors approve the final version to be published and agree to be accountable to all aspects of the work.

Corresponding author

Correspondence to Kera McNelis.

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The authors declare that they have no conflict of interest.

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McNelis, K., Goddard, G., Jenkins, T. et al. Delay in achieving enteral autonomy and growth outcomes in very low birth weight infants with surgical necrotizing enterocolitis. J Perinatol 41, 150–156 (2021). https://doi.org/10.1038/s41372-020-00880-z

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