@article{9ad373a786894848b77dcdefe1f9d93f,
title = "Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants",
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 = "Growth failure, infant, laparotomy, necrotizing enterocolitis, peritoneal drain, spontaneous intestinal perforation",
author = "{The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network} and Speer, {Allison L.} and Lally, {Kevin P.} and Claudia Pedroza and Yuxin Zhang and Poindexter, {Brenda B.} and Chwals, {Walter J.} and Hintz, {Susan R.} and Besner, {Gail E.} and Stevenson, {David K.} and Ohls, {Robin K.} and Truog, {William E.} and Stoll, {Barbara J.} and Rysavy, {Matthew A.} and Abhik Das and Tyson, {Jon E.} and Blakely, {Martin L.} and Polin, {Richard A.} and Caplan, {Michael S.} and S{\'a}nchez, {Pablo J.} and Nelin, {Leif D.} and Moss, {R. Lawrence} and Maitre, {Nathalie L.} and Jadcherla, {Sudarshan R.} and Patricia Luzader and Fortney, {Christine A.} and Julie Gutentag and Yeates, {Keith O.} and Timan, {Christopher J.} and Small, {Kristi L.} and Sullivan, {Rox Ann} and Jacqueline McCool and Melanie Stein and Erin Fearns and Quan, {Lorraine Kelly} and Thakkar, {Rajan K.} and Hague, {Cole D.} and Stephanie Burkhardt and Jessica Purnell and Nelin, {Mary Ann} and Helen Carey and Lindsay Pietruszewski and Laptook, {Abbot R.} and Martin Keszler and Kurkchubasche, {Arlet G.} and Vohr, {Betty R.} and McGowan, {Elisabeth C.} and Hensman, {Angelita M.} and Barbara Alksninis and Kristin Basso and Carmena Bishop and Burke, {Robert T.} and Melinda Caskey and Laurie Hoffman and Katharine Johnson and Keszler, {Mary Lenore} and Leach, {Teresa M.} and Emily Little and Stephens, {Bonnie E.} and Pierre, {Lucille St} and Elisa Vieira and Watson, {Victoria E.} and Hibbs, {Anna Maria} and Newman, {Nancy S.} and Barksdale, {Edward M.} and Payne, {Allison H.} and Wilson-Costello, {Deanne E.} and Siner, {Bonnie S.} and Monika Bhola and Gulgun Yalcinkaya and Pallotto, {Eugenia K.} and Cheri Gauldin and Holcomb, {George M.} and {St Peter}, {Shawn D.} and Kilbride, {Howard W.} and Anne Holmes and Kathy Johnson and Allison Scott and Parimi, {Prabhu S.} and Lisa Gaetano and Kurt Schibler and Helmrath, {Michael A.} and Merhar, {Stephanie L.} and Cahill, {Tanya E.} and Kimberly Yolton and Rebeccah Brown and Gratton, {Teresa L.} and Cathy Grisby and Kristin Kirker and Sandra Wuertz and Cotten, {C. Michael} and Goldberg, {Ronald N.} and Laughon, {Matthew M.} and Rice, {Henry E.} and Adibe, {Obinna O.} and Joanne Finkle and Malcolm, {William F.} and Goldstein, {Ricki F.} and Adamson, {William T.} and Ashley, {Patricia L.} and Fisher, {Kimberley A.} and Sandra Grimes and Gustafson, {Kathryn E.} and Lohmeyer, {Melody B.} and Bose, {Carl L.} and Janice Bernhardt and Gennie Bose and Janice Wereszczak and Kicklighter, {Stephen D.} and Ginger Rhodes-Ryan and Patel, {Ravi M.} and Carlton, {David P.} and Ira Adams-Chapman and Bhatia, {Amina M.} and Hale, {Ellen C.} and Yvonne Loggins and Richard Ricketts and Bottcher, {Diane I.} and Carter, {Sheena L.} and Salathiel Kendrick-Allwood and LaRossa, {Maureen Mulligan} and Colleen Mackie and Gloria Smikle and Comerford, {Lynn C.} and Higgins, {Rosemary D.} and Archer, {Stephanie Wilson} and Sokol, {Gregory M.} and Markel, {Troy A.} and Engum, {Scott A.} and Leys, {Charles M.} and Papile, {Lu Ann} and Heidi Harmon and Herron, {Dianne E.} and Carolyn Lytle and Miller, {Lucy C.} and Minnich, {Heike M.} and Lucy Smiley and Wilson, {Leslie Dawn} and Kennedy, {Kathleen A.} and McDavid, {Georgia E.} and Stephens, {Emily K.} and Tsao, {Kuo Jen} and Elizabeth Allain and Julie Arldt-McAlister and Katrina Burson and Dempsey, {Allison G.} and Duncan, {Andrea F.} and Elizabeth Eason and Mosquera, {Ricardo A.} and Evans, {Patricia W.} and Carmen Garcia and Hall, {Donna J.} and Margarita Jiminez and Janice John and Jones, {Patrick M.} and Amir Khan and Lillie, {M. Layne} and Karen Martin and Perez, {Carrie M.} and Kimberly Rennie and Martin, {Sara C.} and McKee, {Shannon L.} and Michelle Poe and Shawna Rodgers and Siddiki, {Saba Khan} and Daniel Sperry and {Pierce Tate}, {Patti L.} and Wright, {Sharon L.} and Dennis Wallace and Gantz, {Marie G.} and Bann, {Carla M.} and Auman, {Jeanette O.Donnell} and Margaret Crawford and Jenna Gabrio and Newman, {Jamie E.} and {Petrie Huitema}, {Carolyn M.} and Zaterka-Baxter, {Kristin M.} and {Van Meurs}, {Krisa P.} and Ball, {M. Bethany} and Hartman, {Gary E.} and Karl Sylvester and Barbara Bentley and Elizabeth Bruno and DeAnda, {Maria Elena} and DeBattista, {Anne M.} and Huffman, {Lynne C.} and Kohn, {Jean G.} and Casey Krueger and Proud, {Melinda S.} and {St John}, {Nicholas H.} and Hali Weiss and Frantz, {Ivan D.} and Fiascone, {John M.} and MacKinnon, {Brenda L.} and Anne Kurfiss and Ellen Nylen and Church, {Paige T.} and Carlo, {Waldemar A.} and Namasivayam Ambalavanan and Martin, {Colin A.} and Dimmitt, {Reed A.}",
note = "Publisher Copyright: Copyright {\textcopyright} 2024 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2024",
month = sep,
day = "1",
doi = "10.1097/SLA.0000000000006378",
language = "English",
volume = "280",
pages = "432--443",
journal = "Annals of surgery",
issn = "0003-4932",
number = "3",
}