Stoma Closure Improves Head Circumference Growth in Very Preterm Infants after Necrotizing Enterocolitis

2020 ◽  
Author(s):  
Karina Dyrvig Honoré ◽  
Malene Nygaard Johansen ◽  
Lars Rasmussen ◽  
Gitte Zachariassen
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Head Circumference ◽  
International Classification Of Diseases ◽  
University Hospital ◽  
Stoma Closure ◽  
Poor Growth ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Stoma Formation

Abstract Introduction Very preterm infants (VPIs) surgically treated for necrotizing enterocolitis (NEC) are at risk of growth retardation. The aim of this study was to demonstrate and compare growth during the first 6 years of life in VPIs with stoma after NEC surgery with VPIs without NEC surgery. Materials and Methods We included all VPIs surgically treated due to NEC at the Odense University Hospital from August 1, 2004, to July 31, 2008. Outcome on growth was compared with a group of VPIs without NEC. The VPIs with NEC were identified searching the local database using the International Classification of Diseases, 10th Revision diagnosis of NEC (DP77.9). Data on growth were collected from medical files and if not present, the parents reported the data. Results Nineteen VPIs, surgically treated due to NEC, survived to 6 years of age. Median gestational age was 283/7 weeks (245/7–313/7). Median age at NEC surgery and stoma formation was 2.3 weeks (0.1–6.3) and median age at stoma closure was 2.5 months corrected age (CA) (postmenstrual age 36 weeks to CA 6.7 months). Compared with the non-NEC group, VPIs with NEC and stoma demonstrated poor growth, especially in head circumference (HC) with no increase in growth velocity before the time of stoma closure between 2.5- and 3-month CAs. Conclusion Our findings demonstrate poor growth in VPIs after NEC surgery and improved HC growth after stoma closure.

Necrotizing Enterocolitis in a Dutch Cohort of Very Preterm Infants: Prevalence, Mortality, and Long-Term Outcomes

2022 ◽  
Author(s):  
Ceren Imren ◽  
Lotte E. Vlug ◽  
Barbara A. E. de Koning ◽  
Tessa Diertens ◽  
Heleen E. Snel ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Surgical Complication ◽  
Intestinal Failure ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Anastomotic Strictures ◽  
Multidisciplinary Perspective

Abstract Introduction To improve counseling of parents and to guide care strategies, we studied the disease course and outcomes of necrotizing enterocolitis (NEC) up to 2 years of corrected age (CA) from a multidisciplinary perspective. Materials and Methods This was a retrospective cohort study in preterm infants (birth weight < 1,500 g, gestational age < 32 weeks), diagnosed with NEC (Bell's stage ≥ II) from 2008 through 2020. Data on prevalence, mortality, surgery, intestinal failure (IF), growth, and neurodevelopment at 2-year follow-up were separately analyzed for medically and surgically treated children. Results Of 3,456 preterm infants, 200 (6%) were diagnosed with NEC, of whom 135 developed an indication for surgery within 7 days after the diagnosis; 28/135 died before surgery, and 37/107 died after an open-and-close procedure. An enterostomy was constructed in 62 patients and an end-to-end anastomosis in 15. The postoperative course was described for 77 patients, of whom 23 developed surgical complications (12/23 incisional hernias, 9/23 anastomotic strictures), 13/77 a short bowel, and 25/77 IF. Sixty-day survival after birth for medical NEC patients was 88% (hazard ratio [HR]: 0.698; p = 0.318), and for surgically treated NEC patients was 40% (HR: 3.729; p < 0.001). At 2-year follow-up, one patient received parenteral nutrition. Severe delay in weight for age, motor, and cognitive development was seen in 3, 6, and 2%, respectively. Conclusion In this cohort, the mortality rate was high, especially in surgically treated NEC patients. The surgical complication rate is comparable to previous studies, but in surviving patients, persisting IF and severe delay in growth and neurodevelopment at 2 years CA were relatively rare.

scholarly journals Availability of Donor Milk for Very Preterm Infants Decreased the Risk of Necrotizing Enterocolitis without Adversely Impacting Growth or Rates of Breastfeeding

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1895 ◽  
Author(s):  
Débora Cañizo Vázquez ◽  
Sandra Salas García ◽  
Montserrat Izquierdo Renau ◽  
Isabel Iglesias-Platas
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Donor Milk ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Breastfeeding Rates ◽  
Group 2 ◽  
Group 1

Human milk contains non-nutritional factors that promote intestinal maturation and protect against infectious and inflammatory conditions. In the Neonatal Intensive Care Unit (NICU) setting, donor milk (DM) is recommended when availability of own mother’s milk (OMM) is not enough. Our aim was to compare the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in very preterm infants (VPI) after the introduction of DM. Growth and breastfeeding rates were examined as secondary outcomes. Single center, observational and retrospective cohort study comparing 227 VPI admitted to our neonatal unit before (Group 1, n = 99) and after (Group 2, n = 128) DM introduction. Enteral nutrition was started earlier after DM availability (2.6 ± 1.1 vs. 2.1 ± 1 days, p = 0.001). Incidence of NEC decreased in group 2 (9.1% vs. 3.4%, p = 0.055), especially in those born between 28 and 32 weeks (5.4 vs. 0.0%, p = 0.044). Surgical NEC was also less frequent. Suffering NEC was 4 times more likely in group 1 (multivariate analysis). Availability of DM did not impact breastfeeding rates or preterm growth. Our findings support the protective role of DM against NEC, particularly in non-extreme VPI, a group less frequently included in clinical guidelines and research studies on the use of DM.

scholarly journals Nutritional strategies and gut microbiota composition as risk factors for necrotizing enterocolitis in very-preterm infants

2017 ◽  
Vol 106 (3) ◽  
pp. 821-830 ◽  
Author(s):  
Jean-Christophe Rozé ◽  
Pierre-Yves Ancel ◽  
Patricia Lepage ◽  
Laetitia Martin-Marchand ◽  
Ziad Al Nabhani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gut Microbiota ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Microbiota Composition ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Nutritional Strategies ◽  
Gut Microbiota Composition

scholarly journals 1: Very Preterm Infants with Necrotizing Enterocolitis and Sepsis Demonstrate Slower Brain Metabolic Development

2014 ◽  
Vol 19 (6) ◽  
pp. e36-e36
Author(s):  
PD D'Arienzo ◽  
EG Duerden ◽  
V Chau ◽  
A Thompson ◽  
S Belanger ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Generating longitudinal growth charts from preterm infants fed to current recommendations

2020 ◽  
Vol 105 (6) ◽  
pp. 646-651
Author(s):  
Aneurin Young ◽  
Edward T Andrews ◽  
James John Ashton ◽  
Freya Pearson ◽  
R Mark Beattie ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Real World ◽  
Head Circumference ◽  
Web Application ◽  
Care Pathway ◽  
Repeated Measurements ◽  
Growth Charts ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Integrated Care Pathway

ObjectiveTo use repeated measurements of weight, length and head circumference to generate growth centile charts reflecting real-world growth of a population of very preterm infants with a well-described nutritional intake close to current recommendations.DesignInfants born before 30 weeks gestational age (GA) were recruited. Infants received nutrition according to an integrated care pathway, with nutrient intake recorded daily, weight recorded twice-weekly and length and head circumference weekly. The LMS method was used to construct growth centile charts between 24 and 36 weeks corrected GA for each parameter.SettingA single tertiary neonatal unit in England.Patients212 infants (124 male) (median GA at birth: 27.3 weeks, median birth weight: 900 g).ResultsMedian daily energy, protein, carbohydrate and fat intake were within 3% of published recommendations. The total number of measurements recorded was 5944 (3431 for weight, 1227 for length and 1286 for head circumference). Centile charts were formed for each parameter. Data for male and female infants demonstrated similar patterns of growth and were pooled for LMS analysis. A web application was created and published (bit.ly/sotongrowth) to allow infants to be plotted on these charts with changes in SD score of measurements reported and graphically illustrated.ConclusionsThese charts reflect growth in a real-world cohort of preterm infants whose nutrient intakes are close to current recommendations. This work demonstrates the feasibility of forming growth charts from serial measurements of growing preterm infants fed according to current recommendations which will aid clinicians in setting a benchmark for achievable early growth.

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