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Surgical necrotizing enterocolitis but not spontaneous intestinal perforation is associated with adverse neurological outcome at school age

2020; Nature Portfolio; Volume: 10; Issue: 1 Linguagem: Inglês

10.1038/s41598-020-58761-6

2045-2322

Alexander Humberg, Juliane Spiegler, Mats Ingmar Fortmann, Michael Zemlin, Janina Marißen, Isabelle Swoboda, Tanja K. Rausch, Egbert Herting, Wolfgang Göpel, Christoph Härtel, Christian Wieg, Angela Kribs, A von der Wense, Ursula Weller, Thomas Höhn, Dirk Olbertz, Ursula Felderhoff‐Müser, Rainer Rossi, Norbert Teig, Friedhelm Heitmann, Susanne Schmidtke, Bettina Bohnhorst, Matthias Vochem, Holger Michel, Jens Möller, Joachim G. Eichhorn, Jürgen Wintgens, Ralf Böttger, Mechthild Hubert, Michael Dördelmann, Georg Hillebrand, Claudia Roll, Reinhard Jensen, Mario Rüdiger, Julia Sandkötter, Stefan Schäfer, Thomas Schaible, Axel R. Franz, Malik Aydin, Silke Ehlers, Claudius Werner, Thorsten Orlikowsky, Hubert Gerleve, Katja Schneider, Claudius Werner, Kai Böckenholt, K Linnemann, Dirk Müller, Corinna Gebauer, Florian Guthmann, Jochen Reese, Roland Haase, Stephan Seeliger, Helmut Küster, Roland Hentschel, Thorsten Körner, Thomas Brune, Andreas Müller, Thomas H. Frank, Martin Andree Berghäuser, K Dawczynski,

Neonatal Respiratory Health Research

Gastrointestinal complications during the neonatal period, i.e. necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP), are associated with adverse short-term outcome in very-low-birthweight infants (VLBWI, <1500 g birth weight). However, little is known about the neurological outcome of survivors at school age. We analysed data of 2241 infants followed-up at the age of 6 years. To determine the effect of NEC and SIP on cognitive outcome in consideration of other important confounding factors, we used multivariable logistic regression models. In addition, infants with surgical diagnosis of NEC (n = 43) or SIP (n = 41) were compared to NEC (n = 43) or SIP (n = 41) negative controls using Mahalanobis distance matching. Infants with a history for NEC had a three times increased risk (RR 3.0 [1.8-4.2], p < 0.001) to develop IQ scores <85 while history of surgical SIP did not increase the relative risk for lower IQs at school age (RR 1.0 [0.4-2.1], p = 1.000). In a matched-cohort analysis, we confirmed that infants with surgical NEC had lower mean IQ results than unaffected controls (±SD) (85±17 vs. 94±14, p = 0.023) while no differences were found for history of SIP. Our results reflect that the different aetiology and inflammatory extent of NEC and SIP may lead to disparate neurodevelopment trajectories. Hence, our data suggest a potential role of early gut-brain axis distortion in infants with NEC which needs to be further explored.