The gut-brain ConNECtion: exploring the developmental impact of necrotizing enterocolitis on the neonatal brain

Abstract

Necrotizing enterocolitis (NEC) is the leading cause of death from gastrointestinal disease within premature infants, posing a significant concern to infants admitted to the neonatal intensive care unit. In those patients who overcome the disease, there are significant long-term effects that include gastrointestinal effects as well as neurodevelopmental deficits. The pathogenesis of necrotizing enterocolitis and its related brain injury that results in these neurodevelopmental deficits is complex and multifaceted, with much research supporting the idea that NEC-induced inflammation is a major cause of brain injury. Thus, management plans for patients with NEC should include an approach geared towards the reduction of associated complications, such as brain injury. This review is focused on exploring our current understanding of the pathophysiology behind NEC and related brain injury and involvement. IMPACT: This review synthesizes current research on NEC-induced inflammation as a major contributor to brain injury, offering a unified perspective on how gastrointestinal disease can lead to neurodevelopmental deficits in preterm infants.