Bos, M. (Mai) (2021) The effects of necrotizing enterocolitis on short-term neurological status of preterm born infants: Necrotizing enterocolitis and short-term neurological status of preterm born infants: the role of severity and time to full enteral feeding. thesis, Medicine.
Full text available on request.Abstract
Introduction/Aim: The devastating intestinal disease Necrotizing Enterocolitis (NEC) is associated with adverse neurodevelopmental outcomes. Because adequate nutrition is a perquisite for growth and neurodevelopment, a prolonged time to full enteral feeding (FEFt) may underlie these associations. The aim of this study was to investigate the effects of the severity and treatment of NEC on short-term neurological status in infants. Methods: We included infants with a suspicion or diagnosis of NEC≥Bell’s Stage 2A. Short-term neurodevelopment was determined using the General Movement Assessment, including a detailed scoring with the General Movement Optimality Score (5–42 points) at term and Motor Optimality Score (5–28 points) at 3 months corrected age. Differences in GMOS and MOS scores per Bell’s Stage and per treatment regimen (surgical versus conservative) were determined using Kruskal-Wallis and Mann-Whitney-U tests. Associations between FEFt/ minimal enteral feeding (MEF)/MEF to FEF with GMOS/MOS were determined using univariate linear regression analysis. We performed multiple linear regression analysis to correct statistically significant associations on sex and gestational age. Results: We included 22 infants (73% males), median gestational age 28.2 weeks (interquartile range [IQR] 26.8- 30.2), median birth weight 1165 grams (IQR 934-1435). Median MOS for Bell’s Stage 2A was 26.0 (IQR 24.5-27.5), for Stage 2B 24.0 (IQR 21.0-26.0) and for Stage 3 21.5 (IQR 18.0- 23.25), P=0.009. Median MOS for conservative NEC treatment (n=13) was 26.0 (IQR 24.0- 27.0) and for surgical treatment (n=6) 21.5 (IQR 18.0-23.25), P=0.009. Bell’s stage and treatment regimen were still significantly affecting MOS after correcting for sex and gestational age (respectively B=-2.998, confidence interval [CI]=-4.799 – -1.198 , p=0.003 and B=-4.887, CI=-8.453 – -1.321, p=0.011). Bell’s stadium and treatment option were not associated with GMOS. GMOS and MOS did not correlate with FEFt, MEF and time from MEF to FEF. Conclusion: The severity of NEC and surgical treatment are affecting an infant’s neurological status at 12 weeks corrected age. Withholding enteral feeding does not have an effect on neurological status at term-equivalent age or 12 weeks corrected age.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Bos, prof. dr. A.F. and Horst, dr. H.J. ter |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 09:32 |
| Last Modified: | 06 Jan 2022 09:32 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2964 |
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