Effect of necrotizing enterocolitis on neurodevelopment among 52 premature infants

Objective  To investigate the effects of necrotizing enterocolitis (NEC) and its degree of severity on long-term neurodevelopment, in order to provide evidence for early diagnosis and intervention of neurodevelopmental impairment among premature infants.

Methods  A prospective cohort study was conducted. 52 NEC and 104 non-NEC preterm infants admitted to Quanzhou Children's Hospital were recruited as study subjects from Jan, 2018 to Nov, 2021. Gesell developmental scale was used to assess neurodevelopment at toddler's age. The development quotient (DQ) ≤ 85 was defined as neurodevelopmental impairment.The incidence of neurodevelopmental abnormalities and physical development between NEC and non-NEC preterm infants were analyzed.

Results  At corrected age of 25(20,28) months, height-for-age Z-score in the NEC group was significantly lower than that in the non-NEC group − 0.75(− 1.58,0.03) vs. − 0.17(− 0.84,0.38), P = 0.01. The incidence of neurodevelopmental impairment in NEC group was higher than that in non-NEC group (67.3% vs. 35.6%, P < 0.001). The total DQ, gross motor DQ and fine motor DQ in NEC group were lower than those in non-NEC group 84(80,89) vs. 87(82,93), P = 0.01; 88(77,94) vs. 92(85,96), P = 0.03; 89(83,96) vs. 93(87,100), P = 0.01. There was no significant difference in physical development between surgical (n = 25) and internal medical group (n = 27) within NEC group (P > 0.05), but the incidence of neurodevelopmental impairment in the surgical group was significantly higher than that in the internal medical group (88.0% vs. 48.0%, P < 0.05). Within the surgical group, there was no significant difference in physical development and neurodevelopmental impairment between the NEC with short bowel syndrome (SBS) group (n = 4) and NEC without SBS group (n = 21) (P > 0.05), but the DQ in the NEC with SBS group was lower than that in NEC without SBS group 75(62,77) vs. 83(81,85), P < 0.05.

Conclusion  The risk of neurodevelopmental abnormalities is higher in NEC survivors than that in non-NEC. The higher severity degree of the NEC, the higher risk of the adverse neurodevelopmental outcomes.