Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;37(3):411-417.
doi: 10.1007/s00383-020-04825-7. Epub 2021 Jan 11.

Discrepancy between the survival rate and neuropsychological development in postsurgical extremely low-birth-weight infants: a retrospective study over two decades at a single institution

Mitsuru Muto  1 , Koshiro Sugita  2 , Satoshi Ibara  3 , Ryuta Masuya  4 , Makoto Matuskubo  2 , Takafumi Kawano  5 , Yumiko Saruwatari  6 , Seiro Machigashira  5 , Koichi Sakamoto  7 , Kazuhiko Nakame  4 , Shin Shinyama  8 , Motofumi Torikai  3 , Yoshihiro Hayashida  2 , Motoi Mukai  2 , Takamasa Ikee  9 , Ryuichi Shimono  10 , Hiroyuki Noguchi  5   11 , Satoshi Ieiri  2
Affiliations

Discrepancy between the survival rate and neuropsychological development in postsurgical extremely low-birth-weight infants: a retrospective study over two decades at a single institution

Mitsuru Muto et al. Pediatr Surg Int. 2021 Mar.

Abstract

Purpose: Necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI) are major diseases that cause gastrointestinal disorders in extremely low-birth-weight infants (ELBWIs). We conducted a review to compare the postoperative outcomes of ELBWIs with these diseases in our neonatal intensive-care unit.

Methods: A retrospective chart review of ELBWIs surgically treated for NEC (n = 31), FIP (n = 35), and MRI (n = 16) in 2001-2018 was undertaken. This period was divided into early (2001-2005), middle (2006-2010), and late (2011-2018) periods. Data were analyzed with the Cochran-Armitage test. Statistical significance was defined as p < 0.05.

Results: The survival rates in ELBWIs with NEC (early/middle/late: 36.4%/42.9%/61.5%; p = 0.212) and FIP (20%/50%/70.6%; p = 0.012) improved over time; all patients with MRI survived. The neuropsychological development of 24 cases was assessed with the Kyoto Scale of Psychological Development in the Postural-Motor, Cognitive-Adaptative, and Language-Social domains. The mean developmental quotient of all domains was 68.4 (range 18-95) at corrected 1.5 years of age and 69.1 (range 25-108) at chronological 3 years of age, both were considered as poor development. There was no improvement over time (p = 0.899).

Conclusion: Ideal neuropsychological development was not observed with the improvement of survival rate. Less-invasive surgical intervention and adequate postoperative care are required to encourage further development.

Keywords: Extremely low-birth-weight infants; Focal intestinal perforation; Meconium-related ileus; Necrotizing enterocolitis; Neuropsychological development; Prognosis.

PubMed Disclaimer

References

    1. Wadhawan R (2014) neurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis. J Perinatol 34:64–70 - DOI
    1. Sato M, Hamada Y, Kohno M, Ise K, Uchida K, Ogata H, Masuyama H, Morotomi Y, Yasufuku M, Wada M (2017) Neonatal gastrointestinal perforation in Japan: a nationwide survey. Pediatr Surg Int 33:33–41 - DOI
    1. Yagi M, Kohno M, Asagiri K, Ikeda T, Okada T, Kanada S, Kawashima S, Goto Y, Takano S, Yasufuku M, Wada M (2015) Twenty-year trends in neonatal surgery based on a nationwide Japanese surveillance program. Pediatr Surg Int 31:955–962 - DOI
    1. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T (1978) Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 187:1–7 - DOI
    1. Novack CM, Waffarn F, Sills JH, Pousti TJ, Warden MJ, Cunningham MD (1994) Focal intestinal perforation in the extremely-low-birth-weight infant. J Perinatol 14:450–453 - PubMed

LinkOut - more resources