Very low birth weight preterm infants with surgical short bowel syndrome: incidence, morbidity and mortality, and growth outcomes at 18 to 22 months.

Full Abstract

OBJECTIVES:
The objective of this study was to determine the (1) incidence of short bowel syndrome in very low birth weight (<1500 g) infants, (2) associated morbidity and mortality during initial hospitalization, and (3) impact on short-term growth and nutrition in extremely low birth weight (<1000 g) infants.

METHODS:
Infants who were born from January 1, 2002, through June 30, 2005, and enrolled in the National Institute of Child Health and Human Development Neonatal Research Network were studied. Risk factors for developing short bowel syndrome as a result of partial bowel resection (surgical short bowel syndrome) and outcomes were evaluated for all neonates until hospital discharge, death, or 120 days. Extremely low birth weight survivors were further evaluated at 18 to 22 months' corrected age for feeding methods and growth.

RESULTS:
The incidence of surgical short bowel syndrome in this cohort of 12316 very low birth weight infants was 0.7%. Necrotizing enterocolitis was the most common diagnosis associated with surgical short bowel syndrome. More very low birth weight infants with short bowel syndrome (20%) died during initial hospitalization than those without necrotizing enterocolitis or short bowel syndrome (12%) but fewer than the infants with surgical necrotizing enterocolitis without short bowel syndrome (53%). Among 5657 extremely low birth weight infants, the incidence of surgical short bowel syndrome was 1.1%. At 18 to 22 months, extremely low birth weight infants with short bowel syndrome were more likely to still require tube feeding (33%) and to have been rehospitalized (79%). Moreover, these infants had growth delay with shorter lengths and smaller head circumferences than infants without necrotizing enterocolitis or short bowel syndrome.

CONCLUSIONS:
Short bowel syndrome is rare in neonates but has a high mortality rate. At 18 to 22 months' corrected age, extremely low birth weight infants with short bowel syndrome were more likely to have growth failure than infants without short bowel syndrome.

Learn Faster Today Improve your study skills

Author information

Author/s: Cole, Conrad R (CR); Hansen, Nellie I (NI); Higgins, Rosemary D (RD); Ziegler, Thomas R (TR); Stoll, Barbara J (BJ); Eunice Kennedy Shriver NICHD Neonatal Research Network;

Affiliation: Emory University School of Medicine, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, 2015 Uppergate Dr, Atlanta, GA 30322, USA. conrad_cole(-atsign-)oz.ped.emory.edu

Grants: 1KL2RR025009 (Agency:United States NCRR) ; 5K12RR017643 (Agency:United States NCRR) ; M01 RR16587 (Agency:United States NCRR) ; M01 RR30 (Agency:United States NCRR) ; M01 RR39 (Agency:United States NCRR) ; M01 RR44 (Agency:United States NCRR) ; M01 RR6022 (Agency:United States NCRR) ; M01 RR633 (Agency:United States NCRR) ; M01 RR70 (Agency:United States NCRR) ; M01 RR7122 (Agency:United States NCRR) ; M01 RR750 (Agency:United States NCRR) ; M01 RR80 (Agency:United States NCRR) ; M01 RR8084 (Agency:United States NCRR) ; U01 HD36790 (Agency:United States NICHD) ; U10 HD21364 (Agency:United States NICHD) ; U10 HD21373 (Agency:United States NICHD) ; U10 HD21385 (Agency:United States NICHD) ; U10 HD21397 (Agency:United States NICHD) ; U10 HD27851 (Agency:United States NICHD) ; U10 HD27853 (Agency:United States NICHD) ; U10 HD27856 (Agency:United States NICHD) ; U10 HD27871 (Agency:United States NICHD) ; U10 HD27880 (Agency:United States NICHD) ; U10 HD27904 (Agency:United States NICHD) ; U10 HD34216 (Agency:United States NICHD) ; U10 HD40461 (Agency:United States NICHD) ; U10 HD40492 (Agency:United States NICHD) ; U10 HD40498 (Agency:United States NICHD) ; U10 HD40521 (Agency:United States NICHD) ; U10 HD40689 (Agency:United States NICHD) ; UL1 RR24139 (Agency:United States NCRR)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Pediatrics (Pediatrics), published in United States. (Language: eng)

Reference: 2008-Sep; vol 122 (issue 3) : pp e573-82

Dates: Created 2008/09/02; Completed 2008/09/16;

PMID: 18762491, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Child Development - physiology
Digestive System Surgical Procedures - adverse effects
Enterocolitis, Necrotizing - surgery
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Infant, Premature - growth & development

Infant, Very Low Birth Weight - growth & development
Male
Morbidity - trends
Postoperative Complications
Pregnancy
Retrospective Studies
Short Bowel Syndrome - etiology; mortality
Survival Rate - trends
Time Factors
United States - epidemiology

These are the highest related articles currently in the database:

See 100+ related articles.