OBJECTIVE: To determine the growth and neurodevelopmental outcome, as well as predictors of the latter in extremely low-birth-weight (ELBW) infants with definitive necrotizing enterocolitis (NEC).

STUDY DESIGN: Case–control analysis. In all, 17 ELBW infants< 1000 g with Stage 2 or 3 NEC were matched to 51 control infants without NEC. Demographics, clinical course, growth, and neurodevelopmental outcome were compared.

RESULTS: Demographic and clinical characteristics of both groups were similar except that NEC infants had more culture-proven sepsis (59 vs 24%, p= 0.02), longer intubation (36 vs 16 days, p= 0.003) and longer hospital stay (134 vs 86 days, p< 0.001). At 18 to 22 months corrected age BSID-II mental scores (MDI) were similar between groups (74±14 vs 81±13, p= 0.2). However, the psychomotor index (PDI)(66±18 vs 88±14), the proportion with abnormal neurologic examination (54 vs 9%), subnormal height (38 vs 3%) and head circumference (23 vs 0%) were significantly higher in NEC infants (p< 0.05). A logistic model identified NEC and chronic lung disease as predictors for abnormal PDI and MDI, respectively.

CONCLUSIONS: NEC and its comorbidities are associated with severe neurodevelopmental and growth delay in ELBW infants.