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CC BY-NC-ND 4.0 · Am J Perinatol 2024; 41(S 01): e1190-e1196
DOI: 10.1055/s-0042-1760445
Original Article

Analysis of Postoperative Outcomes and Extrauterine Growth Retardation in Preterm Infants with Necrotizing Enterocolitis: A Retrospective Study

Yifan Sun   *
1   Department of Neonatology, School of Medicine, Shanghai Jiao Tong University, Shanghai Children's Hospital, Shanghai, China
,
Zhen Gao   *
1   Department of Neonatology, School of Medicine, Shanghai Jiao Tong University, Shanghai Children's Hospital, Shanghai, China
,
Wenchao Hong
1   Department of Neonatology, School of Medicine, Shanghai Jiao Tong University, Shanghai Children's Hospital, Shanghai, China
,
Xiaohui Gong
1   Department of Neonatology, School of Medicine, Shanghai Jiao Tong University, Shanghai Children's Hospital, Shanghai, China
,
Cheng Cai
1   Department of Neonatology, School of Medicine, Shanghai Jiao Tong University, Shanghai Children's Hospital, Shanghai, China
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Funding None.
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Abstract

Objective High mortality and extrauterine growth retardation (EUGR) remain serious problems in preterm infants after necrotizing enterocolitis (NEC) surgery. This study investigated the risk factors for mortality and EUGR in preterm infants after NEC surgery.

Study Design The risk factors were analyzed retrospectively by univariate analysis and multivariate logistic regression analysis in 52 preterm infants, who underwent NEC surgery and were hospitalized in neonatology department of Shanghai Children's Hospital between May 2014 and December 2021. Patients were divided into survival and death groups. Survivors were divided into two groups according to whether EUGR occurred when they achieved full enteral feeding after surgery.

Results The mortality of preterm infants after NEC surgery was 26.9% (14/52). About 55.3% (21/38) of survivors developed postoperative EUGR. (1) Age at surgery, proportion of shock, and intestinal perforation differed significantly between the survival and death groups (p = 0.001, 0.005, and 0.02, respectively). Shock (p = 0.02, odds ratio [OR] = 8.86, 95% confidence interval [CI]: 1.43–55.10) and intestinal perforation (p = 0.03, OR = 6.12, 95% CI: 1.16–32.41) were significant risk factors for death. (2) Compared with the non-EUGR group, proportion of preoperative EUGR, postoperative 1-week calories, and parenteral nutrition time differed significantly in EUGR group (p = 0.001, 0.01, and 0.04, respectively). Preoperative EUGR (p = 0.02, OR = 18.63, 95%CI: 1.77–196.42) was a significant risk factor for postoperative EUGR.

Conclusion Shock and intestinal perforation are significant risk factors for death in preterm infants after NEC surgery. Survivors are prone to EUGR, and preoperative EUGR is a significant risk factor. In addition, adequate caloric intake and achievement of full enteral feeding as soon as possible may be beneficial to improve EUGR of preterm infants after NEC surgery.

Key Points

  • Shock and intestinal perforation are risk factors for death in preterm infants after NEC surgery.

  • Preoperative EUGR is a risk factor for postoperative EUGR in preterm infants after NEC surgery.

  • Active correction of shock and avoiding intestinal perforation may help improve the outcomes.

Keywords

extrauterine growth retardation - necrotizing enterocolitis - outcomes - preterm infants - surgery

* Contributed equally.




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Eingereicht: 27. August 2022

Angenommen: 08. Dezember 2022

Artikel online veröffentlicht:
16. Januar 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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