Also Noted

Necrotizing enterocolitis (NEC) is a common serious complication for preterm infants. It is associated with high morbidity and mortality. A number of investigators have observed an increased incidence of neurodevelopmental impairment (NDI) in children who have survived NEC. This increased incidence is felt to be related to the increased proinflammatory cytokines that are released during the NEC episode. Schulzke et al undertook this meta-analysis to examine whether there was an increased risk and whether the risk was higher in surgically managed NEC. Although there was significant heterogeneity in the studies, and variation in how NDI was defined, the investigators did find that the risk of long-term NDI was significantly higher for those children with at least stage II NEC versus no NEC (odds ratio, 1.82; 95% CI, 1.46-2.27). In addition, infants with NEC who required surgery were at higher risk for NDI compared with infants treated medically (odds ratio, 1.99; 95% CI, 1.26-3.14). Physicians who provide follow-up care for preterm infants should be aware of these risks and include them when counseling parents of children who have had NEC.