Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants

Authors

• Allison L Speer
• Kevin P Lally
• Claudia Pedroza
• Yuxin Zhang
• Brenda B Poindexter
• Walter J Chwals
• Susan R Hintz
• Gail E Besner
• David K Stevenson
• Robin K Ohls
• William E Truog
• Barbara J Stoll
• Matthew A Rysavy
• Abhik Das
• Jon E Tyson
• Martin L Blakely

Language

English

Publication Date

9-1-2024

Journal

Annals of Surgery

DOI

10.1097/SLA.0000000000006378

PMID

39264354

PMCID

PMC11708816

PubMedCentral® Posted Date

9-1-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: We aimed to determine the incidence of growth failure in infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) and whether initial laparotomy versus peritoneal drainage (PD) impacted the likelihood of growth failure.

Summary background data: Infants with surgical NEC and SIP have high mortality, and most have neurodevelopmental impairment and poor growth. Existing literature on growth outcomes for these infants is limited.

Methods: This is a preplanned secondary study of the Necrotizing Enterocolitis Surgery Trial dataset. The primary outcome was growth failure (Z-score for weight < -2.0) at 18 to 22 months. We used logistic regression, including diagnosis and treatment, as covariates. Secondary outcomes were analyzed using the Fisher exact or Pearson χ2 test for categorical variables and the Wilcoxon rank sum test or one-way ANOVA for continuous variables.

Results: Among 217 survivors, 207 infants (95%) had primary outcome data. Growth failure at 18 to 22 months occurred in 24/50 (48%) of NEC infants versus 65/157 (42%) SIP (P=0.4). The mean weight-for-age Z-score at 18 to 22 months in NEC infants was -2.05±0.99 versus -1.84±1.09 SIP (P=0.2), and the predicted mean weight-for-age Z-score SIP (Beta -0.27; 95% CI: -0.53, -0.01; P=0.041). Median declines in weight-for-age Z-score between birth and 18 to 22 months were significant in all infants but most severe (>2) in NEC infants (P=0.2).

Conclusions: This first ever prospective study of growth outcomes in infants with surgical NEC or SIP demonstrates that growth failure is very common, especially in infants with NEC, and persists at 18-22 months.

Keywords

Humans, Enterocolitis, Necrotizing, Intestinal Perforation, Male, Female, Infant, Infant, Newborn, Drainage, Laparotomy, Spontaneous Perforation, Growth Disorders, Infant, Premature

Published Open-Access

yes

Recommended Citation

Speer, Allison L; Lally, Kevin P; Pedroza, Claudia; et al., "Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants" (2024). Faculty, Staff and Student Publications. 4099.
https://digitalcommons.library.tmc.edu/uthmed_docs/4099