Mortality and neurodevelopmental outcomes at 2 years' corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study

Eur J Pediatr. 2024 Sep;183(9):4019-4028. doi: 10.1007/s00431-024-05675-4. Epub 2024 Jul 2.

Abstract

Purpose: The primary objective was to evaluate the impact of necrotising enterocolitis (NEC) and spontaneous intestinal perforation (SIP) on mortality and neurodevelopmental outcomes at 2 years' corrected age (CA) in infants born before 32 weeks' gestation (WG).

Methods: We studied neurodevelopment at 2 years' CA of infants with NEC or SIP who were born before 32 WG from the EPIPAGE-2 cohort study. The primary outcome was death or the presence of moderate-to-severe motor or sensory disability defined by moderate-to-severe cerebral palsy or hearing or visual disability. The secondary outcome was developmental delay defined by a score < 2 SDs below the mean for any of the five domains of the Ages and Stages Questionnaire.

Results: At 2 years' CA, 46% of infants with SIP, 34% of infants with NEC, and 14% of control infants died or had a moderate-to-severe sensorimotor disability (p < 0.01). This difference was mainly due to an increase in in-hospital mortality in the infants with SIP or NEC. Developmental delay at 2 years' CA was more frequent for infants with SIP than controls (70.8% vs 44.0%, p = 0.02) but was similar for infants with NEC and controls (49.3% vs 44.0%, p = 0.5). On multivariate analysis, the likelihood of developmental delay was associated with SIP (adjusted odds ratio = 3.0, 95% CI 1.0-9.1) but not NEC as compared with controls.

Conclusion: NEC and SIP significantly increased the risk of death or sensorimotor disability at 2 years' CA. SIP was also associated with risk of developmental delay at 2 years' CA.

Keywords: Digestive surgery; Mortality; Necrotizing enterocolitis; Neurodevelopment; Prematurity; Spontaneous intestinal perforation.

Publication types

  • Multicenter Study

MeSH terms

  • Case-Control Studies
  • Child, Preschool
  • Cohort Studies
  • Developmental Disabilities* / epidemiology
  • Developmental Disabilities* / etiology
  • Enterocolitis, Necrotizing* / complications
  • Enterocolitis, Necrotizing* / mortality
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Infant
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases* / mortality
  • Intestinal Perforation* / etiology
  • Intestinal Perforation* / mortality
  • Male
  • Neurodevelopmental Disorders / epidemiology
  • Neurodevelopmental Disorders / etiology