Mortality and neurodevelopmental outcomes at 2 years' corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study

Victoria Butler¹, Ludovic Treluyer^{2

3}, Juliana Patkaï², Aline Biset⁴, Pierre-Henri Jarreau^{2

3

5}, Pierre-Yves Ancel^{3

5

6

7}, Jean-Christophe Rozé^{7

8

9}, Laetitia Marchand-Martin^{3

7}, Mélanie Durox^{3

7}, Alexandre Lapillonne^{7

10

11}, Jean-Charles Picaud^{7

12

13}, Delphine Mitanchez^{7

14}, Charlotte Tscherning^{7

15

16}, Valérie Biran^{7

17

18}, Gilles Cambonie^{7

19

20}, Emmanuel Lopez⁷, Jean-Michel Hascoet^{7

21

22}, Luc Desfrere^{7

23}, Clément Chollat^{4

24}, Elodie Zana-Taïeb^{2

25}, Héloïse Torchin^{2

3}

Affiliations

¹ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Paris Cité University, Cochin Hospital, 53 Avenue de L'Observatoire, Paris, 75014, France. victoria.butler@aphp.fr.
² Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Paris Cité University, Cochin Hospital, 53 Avenue de L'Observatoire, Paris, 75014, France.
³ Paris Cité University, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRAE, Paris, 75006, France.
⁴ Department of Neonatal Paediatrics, Trousseau Hospital, Assistance Publique - Hôpitaux de Paris, Sorbonne University, Paris, France.
⁵ FHU Prema, Paris, France.
⁶ Clinical Investigation Center P1419, Assistance Publique - Hôpitaux de Paris, Paris, France.
⁷ Nutrition EPIPAGE-2 Study Group, Paris, France.
⁸ Department of Neonatology, CHU Nantes, Nantes, France.
⁹ UMR PhAN 1280 INRAE, CIC004 INSERM, Nantes, France.
¹⁰ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.
¹¹ URP 7328, Paris Cité University, Paris, France.
¹² Department of Neonatology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, 69677, France.
¹³ CarMen, INSERM, INRA, Université Claude Bernard Lyon 1, Pierre-Bénite, Lyon, 69310, France.
¹⁴ Department of Neonatology, Bretonneau Hospital, François Rabelais University, Tours, 37000, France.
¹⁵ Division of Neonatology, Oslo University Hospital, Oslo, 0372, Norway.
¹⁶ Infinity, University of Toulouse, INSERM, CNRS, UPS, Toulouse, France.
¹⁷ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.
¹⁸ INSERM U1141, Paris Cité University, Paris, France.
¹⁹ Department of Neonatology, CHU Montpellier, Montpellier University, Montpellier, France.
²⁰ INSERM UMR 1058, University of Montpellier, Montpellier, France.
²¹ Neonatology Department, Maternité Régionale Universitaire Adolphe Pinard - Nancy University, Nancy, France.
²² DevAH, University of Lorraine, Vandoeuvre-Les-Nancy, France.
²³ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Louis Mourier Hospital, Colombes, France.
²⁴ NeuroDiderot, INSERM, Paris Cité University, Paris, France.
²⁵ INSERM U955, IMRB, Créteil, France.

PMID: 38955846
DOI: 10.1007/s00431-024-05675-4

Multicenter Study

Mortality and neurodevelopmental outcomes at 2 years' corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study

Victoria Butler et al. Eur J Pediatr. 2024 Sep.

. 2024 Sep;183(9):4019-4028.

doi: 10.1007/s00431-024-05675-4. Epub 2024 Jul 2.

Authors

Affiliations

¹ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Paris Cité University, Cochin Hospital, 53 Avenue de L'Observatoire, Paris, 75014, France. victoria.butler@aphp.fr.
² Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Paris Cité University, Cochin Hospital, 53 Avenue de L'Observatoire, Paris, 75014, France.
³ Paris Cité University, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRAE, Paris, 75006, France.
⁴ Department of Neonatal Paediatrics, Trousseau Hospital, Assistance Publique - Hôpitaux de Paris, Sorbonne University, Paris, France.
⁵ FHU Prema, Paris, France.
⁶ Clinical Investigation Center P1419, Assistance Publique - Hôpitaux de Paris, Paris, France.
⁷ Nutrition EPIPAGE-2 Study Group, Paris, France.
⁸ Department of Neonatology, CHU Nantes, Nantes, France.
⁹ UMR PhAN 1280 INRAE, CIC004 INSERM, Nantes, France.
¹⁰ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.
¹¹ URP 7328, Paris Cité University, Paris, France.
¹² Department of Neonatology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, 69677, France.
¹³ CarMen, INSERM, INRA, Université Claude Bernard Lyon 1, Pierre-Bénite, Lyon, 69310, France.
¹⁴ Department of Neonatology, Bretonneau Hospital, François Rabelais University, Tours, 37000, France.
¹⁵ Division of Neonatology, Oslo University Hospital, Oslo, 0372, Norway.
¹⁶ Infinity, University of Toulouse, INSERM, CNRS, UPS, Toulouse, France.
¹⁷ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.
¹⁸ INSERM U1141, Paris Cité University, Paris, France.
¹⁹ Department of Neonatology, CHU Montpellier, Montpellier University, Montpellier, France.
²⁰ INSERM UMR 1058, University of Montpellier, Montpellier, France.
²¹ Neonatology Department, Maternité Régionale Universitaire Adolphe Pinard - Nancy University, Nancy, France.
²² DevAH, University of Lorraine, Vandoeuvre-Les-Nancy, France.
²³ Neonatal Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Louis Mourier Hospital, Colombes, France.
²⁴ NeuroDiderot, INSERM, Paris Cité University, Paris, France.
²⁵ INSERM U955, IMRB, Créteil, France.

PMID: 38955846
DOI: 10.1007/s00431-024-05675-4

Abstract

Purpose: The primary objective was to evaluate the impact of necrotising enterocolitis (NEC) and spontaneous intestinal perforation (SIP) on mortality and neurodevelopmental outcomes at 2 years' corrected age (CA) in infants born before 32 weeks' gestation (WG).

Methods: We studied neurodevelopment at 2 years' CA of infants with NEC or SIP who were born before 32 WG from the EPIPAGE-2 cohort study. The primary outcome was death or the presence of moderate-to-severe motor or sensory disability defined by moderate-to-severe cerebral palsy or hearing or visual disability. The secondary outcome was developmental delay defined by a score < 2 SDs below the mean for any of the five domains of the Ages and Stages Questionnaire.

Results: At 2 years' CA, 46% of infants with SIP, 34% of infants with NEC, and 14% of control infants died or had a moderate-to-severe sensorimotor disability (p < 0.01). This difference was mainly due to an increase in in-hospital mortality in the infants with SIP or NEC. Developmental delay at 2 years' CA was more frequent for infants with SIP than controls (70.8% vs 44.0%, p = 0.02) but was similar for infants with NEC and controls (49.3% vs 44.0%, p = 0.5). On multivariate analysis, the likelihood of developmental delay was associated with SIP (adjusted odds ratio = 3.0, 95% CI 1.0-9.1) but not NEC as compared with controls.

Conclusion: NEC and SIP significantly increased the risk of death or sensorimotor disability at 2 years' CA. SIP was also associated with risk of developmental delay at 2 years' CA.

Keywords: Digestive surgery; Mortality; Necrotizing enterocolitis; Neurodevelopment; Prematurity; Spontaneous intestinal perforation.

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References

1. Ancel P-Y, Goffinet F, EPIPAGE-2 Writing Group et al (2015) Survival and morbidity of preterm children born at 22 through 34 weeks’ gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatr 169:230–238. https://doi.org/10.1001/jamapediatrics.2014.3351 - DOI - PubMed
1. Hayakawa M, Taguchi T, Urushihara N et al (2015) Outcome in VLBW infants with surgical intestinal disorder at 18 months of corrected age: VLBWI and surgical intestinal disorder. Pediatr Int 57:633–638. https://doi.org/10.1111/ped.12594 - DOI - PubMed
1. Jones IH, Hall NJ (2020) Contemporary outcomes for infants with necrotizing enterocolitis—a systematic review. J Pediatr S0022347619315197. https://doi.org/10.1016/j.jpeds.2019.11.011
1. Shah TA, Meinzen-Derr J, Gratton T et al (2012) Hospital and neurodevelopmental outcomes of extremely low-birth-weight infants with necrotizing enterocolitis and spontaneous intestinal perforation. J Perinatol 32:552–558. https://doi.org/10.1038/jp.2011.176 - DOI - PubMed
1. for NICHD Neonatal Research Network, Wadhawan R, Oh W et al (2014) Neurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis. J Perinatol 34:64–70. https://doi.org/10.1038/jp.2013.128 - DOI

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Mortality and neurodevelopmental outcomes at 2 years' corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study

Affiliations

Mortality and neurodevelopmental outcomes at 2 years' corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous