Necrotizing Enterocolitis in Infants with Periventricular Hemorrhagic Infarction: Associations and Outcomes
Background: Necrotizing enterocolitis (NEC) and periventricular hemorrhagic infarction (PVHI) are complications of prematurity associated with poor neurodevelopmental outcomes. Objectives: We characterized temporal and causal associations between NEC and type of PVHI as well as associations with out...
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| Veröffentlicht in: | Neonatology (Basel, Switzerland) Switzerland), 2011-01, Vol.99 (2), p.97-103 |
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| creator | Maitre, N.L. Marshall, D.D. Goldstein, R.F. Slaughter, J.C. Price, W.A. |
| description | Background: Necrotizing enterocolitis (NEC) and periventricular hemorrhagic infarction (PVHI) are complications of prematurity associated with poor neurodevelopmental outcomes. Objectives: We characterized temporal and causal associations between NEC and type of PVHI as well as associations with outcomes. Methods: This was a multicenter retrospective study of infants with birth weight 70 was greatest for infants with unilateral PVHI versus bilateral PVHI, although the presence of NEC was associated with worse cognitive outcomes in both groups. Conclusions: Premature infants with PVHI often subsequently develop NEC, especially if they have bilateral PVHI and are exposed to indomethacin. While NEC results in worse neurodevelopmental outcomes, PVHI severity appears more important to the outcome of these infants. |
| doi_str_mv | 10.1159/000313960 |
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Objectives: We characterized temporal and causal associations between NEC and type of PVHI as well as associations with outcomes. Methods: This was a multicenter retrospective study of infants with birth weight <1,500 g and diagnosis of PVHI by a pediatric radiologist at 3 neonatal intensive care units in North Carolina, USA, between January 1998 and December 2004. NEC was confirmed using radiological and surgical pathology findings. Infants were assessed by 3 years using the Bayley Scales of Infant Development, second edition. Results: 35 of 112 (31%) of study patients developed NEC. NEC was diagnosed subsequent to PVHI by a median of 16.6 days (95% CI [9.5, 24.9], p < 0.0001). Indomethacin use and the presence of bilateral PVHI were associated with an increased risk of subsequent NEC (OR 2.8, 95% CI [1.1, 7.2] and OR 2.4, 95% CI [1.1, 5.7], respectively). Having bilateral versus unilateral PVHI was associated with a 2.34-fold increased risk of death (95% CI [1.27, 4.33], p = 0.007). NEC was not associated with worse motor outcomes in this population. Overall, the probability of a mental development index >70 was greatest for infants with unilateral PVHI versus bilateral PVHI, although the presence of NEC was associated with worse cognitive outcomes in both groups. Conclusions: Premature infants with PVHI often subsequently develop NEC, especially if they have bilateral PVHI and are exposed to indomethacin. While NEC results in worse neurodevelopmental outcomes, PVHI severity appears more important to the outcome of these infants.</description><identifier>ISSN: 1661-7800</identifier><identifier>EISSN: 1661-7819</identifier><identifier>DOI: 10.1159/000313960</identifier><identifier>PMID: 20664299</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Chi-Square Distribution ; Developmental Disabilities - etiology ; Enterocolitis, Necrotizing - complications ; Enterocolitis, Necrotizing - physiopathology ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intracranial Hemorrhages - complications ; Intracranial Hemorrhages - physiopathology ; North Carolina ; Original Paper ; Retrospective Studies</subject><ispartof>Neonatology (Basel, Switzerland), 2011-01, Vol.99 (2), p.97-103</ispartof><rights>2010 S. Karger AG, Basel</rights><rights>Copyright © 2010 S. Karger AG, Basel.</rights><rights>Copyright (c) 2011 S. Karger AG, Basel</rights><rights>Copyright © 2010 by S. Karger AG, Basel 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-8a024f37576be761897a557d7be1e89e5d2ed56ccfc532223aae560c58615e313</citedby><cites>FETCH-LOGICAL-c422t-8a024f37576be761897a557d7be1e89e5d2ed56ccfc532223aae560c58615e313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20664299$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maitre, N.L.</creatorcontrib><creatorcontrib>Marshall, D.D.</creatorcontrib><creatorcontrib>Goldstein, R.F.</creatorcontrib><creatorcontrib>Slaughter, J.C.</creatorcontrib><creatorcontrib>Price, W.A.</creatorcontrib><title>Necrotizing Enterocolitis in Infants with Periventricular Hemorrhagic Infarction: Associations and Outcomes</title><title>Neonatology (Basel, Switzerland)</title><addtitle>Neonatology</addtitle><description>Background: Necrotizing enterocolitis (NEC) and periventricular hemorrhagic infarction (PVHI) are complications of prematurity associated with poor neurodevelopmental outcomes. Objectives: We characterized temporal and causal associations between NEC and type of PVHI as well as associations with outcomes. Methods: This was a multicenter retrospective study of infants with birth weight <1,500 g and diagnosis of PVHI by a pediatric radiologist at 3 neonatal intensive care units in North Carolina, USA, between January 1998 and December 2004. NEC was confirmed using radiological and surgical pathology findings. Infants were assessed by 3 years using the Bayley Scales of Infant Development, second edition. Results: 35 of 112 (31%) of study patients developed NEC. NEC was diagnosed subsequent to PVHI by a median of 16.6 days (95% CI [9.5, 24.9], p < 0.0001). Indomethacin use and the presence of bilateral PVHI were associated with an increased risk of subsequent NEC (OR 2.8, 95% CI [1.1, 7.2] and OR 2.4, 95% CI [1.1, 5.7], respectively). Having bilateral versus unilateral PVHI was associated with a 2.34-fold increased risk of death (95% CI [1.27, 4.33], p = 0.007). NEC was not associated with worse motor outcomes in this population. Overall, the probability of a mental development index >70 was greatest for infants with unilateral PVHI versus bilateral PVHI, although the presence of NEC was associated with worse cognitive outcomes in both groups. Conclusions: Premature infants with PVHI often subsequently develop NEC, especially if they have bilateral PVHI and are exposed to indomethacin. While NEC results in worse neurodevelopmental outcomes, PVHI severity appears more important to the outcome of these infants.</description><subject>Chi-Square Distribution</subject><subject>Developmental Disabilities - etiology</subject><subject>Enterocolitis, Necrotizing - complications</subject><subject>Enterocolitis, Necrotizing - physiopathology</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Intracranial Hemorrhages - complications</subject><subject>Intracranial Hemorrhages - physiopathology</subject><subject>North Carolina</subject><subject>Original Paper</subject><subject>Retrospective Studies</subject><issn>1661-7800</issn><issn>1661-7819</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkcFLHDEUxoNU1KoH76WEXsTD2iQzSSY9FERsFaR6aM8hm3mzG51JNMlY7F_frLsdrBB4eeT3Pr68D6EjSk4p5eozIaSilRJkC-1RIehMNlS9m-6E7KL3Kd0RwjkXbAftMiJEzZTaQ_c_wMaQ3R_nF_jCZ4jBht5ll7Dz-Mp3xueEf7u8xLcQ3RP4HJ0dexPxJQwhxqVZOPsCRptd8F_wWUrBOrNqEja-xTdjtmGAdIC2O9MnONzUffTr28XP88vZ9c33q_Oz65mtGcuzxhBWd5XkUsxBCtooaTiXrZwDhUYBbxm0XFjbWV4xxipjgAtieSMoh7KIffR1rfswzgdo7cqz6fVDdIOJzzoYp_9_8W6pF-FJSyLL4UXgeCMQw-MIKevBJQt9bzyEMemmVnVFZcUK-ekNeRfG6MvvdMOpIKpqVIFO1lDZdEoRuskKJXoVoJ4CLOzH194n8l9iBfiwBu5NXECcgM38X-f1oNw</recordid><startdate>20110101</startdate><enddate>20110101</enddate><creator>Maitre, N.L.</creator><creator>Marshall, D.D.</creator><creator>Goldstein, R.F.</creator><creator>Slaughter, J.C.</creator><creator>Price, W.A.</creator><general>S. 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Marshall, D.D. ; Goldstein, R.F. ; Slaughter, J.C. ; Price, W.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-8a024f37576be761897a557d7be1e89e5d2ed56ccfc532223aae560c58615e313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Chi-Square Distribution</topic><topic>Developmental Disabilities - etiology</topic><topic>Enterocolitis, Necrotizing - complications</topic><topic>Enterocolitis, Necrotizing - physiopathology</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Very Low Birth Weight</topic><topic>Intracranial Hemorrhages - complications</topic><topic>Intracranial Hemorrhages - physiopathology</topic><topic>North Carolina</topic><topic>Original Paper</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maitre, N.L.</creatorcontrib><creatorcontrib>Marshall, D.D.</creatorcontrib><creatorcontrib>Goldstein, R.F.</creatorcontrib><creatorcontrib>Slaughter, J.C.</creatorcontrib><creatorcontrib>Price, W.A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neonatology (Basel, Switzerland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maitre, N.L.</au><au>Marshall, D.D.</au><au>Goldstein, R.F.</au><au>Slaughter, J.C.</au><au>Price, W.A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Necrotizing Enterocolitis in Infants with Periventricular Hemorrhagic Infarction: Associations and Outcomes</atitle><jtitle>Neonatology (Basel, Switzerland)</jtitle><addtitle>Neonatology</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>99</volume><issue>2</issue><spage>97</spage><epage>103</epage><pages>97-103</pages><issn>1661-7800</issn><eissn>1661-7819</eissn><abstract>Background: Necrotizing enterocolitis (NEC) and periventricular hemorrhagic infarction (PVHI) are complications of prematurity associated with poor neurodevelopmental outcomes. Objectives: We characterized temporal and causal associations between NEC and type of PVHI as well as associations with outcomes. Methods: This was a multicenter retrospective study of infants with birth weight <1,500 g and diagnosis of PVHI by a pediatric radiologist at 3 neonatal intensive care units in North Carolina, USA, between January 1998 and December 2004. NEC was confirmed using radiological and surgical pathology findings. Infants were assessed by 3 years using the Bayley Scales of Infant Development, second edition. Results: 35 of 112 (31%) of study patients developed NEC. NEC was diagnosed subsequent to PVHI by a median of 16.6 days (95% CI [9.5, 24.9], p < 0.0001). Indomethacin use and the presence of bilateral PVHI were associated with an increased risk of subsequent NEC (OR 2.8, 95% CI [1.1, 7.2] and OR 2.4, 95% CI [1.1, 5.7], respectively). Having bilateral versus unilateral PVHI was associated with a 2.34-fold increased risk of death (95% CI [1.27, 4.33], p = 0.007). NEC was not associated with worse motor outcomes in this population. Overall, the probability of a mental development index >70 was greatest for infants with unilateral PVHI versus bilateral PVHI, although the presence of NEC was associated with worse cognitive outcomes in both groups. Conclusions: Premature infants with PVHI often subsequently develop NEC, especially if they have bilateral PVHI and are exposed to indomethacin. While NEC results in worse neurodevelopmental outcomes, PVHI severity appears more important to the outcome of these infants.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>20664299</pmid><doi>10.1159/000313960</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Chi-Square Distribution Developmental Disabilities - etiology Enterocolitis, Necrotizing - complications Enterocolitis, Necrotizing - physiopathology Humans Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Intracranial Hemorrhages - complications Intracranial Hemorrhages - physiopathology North Carolina Original Paper Retrospective Studies |
| title | Necrotizing Enterocolitis in Infants with Periventricular Hemorrhagic Infarction: Associations and Outcomes |
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