Necrotizing enterocolitis in neonates: Has the brain taken a hit 10 years later?

BACKGROUND: The neonate with necrotizing enterocolitis (NEC) is at risk of developing poor neurodevelopmental outcomes. There is a dearth of long-term follow-up studies in this field, with a majority of studies reporting a follow-up duration of 2 years. The aim of this study was to assess neurodevelopment of babies diagnosed with NEC more than a decade ago. This study was carried out in a tertiary hospital with neonatal surgery and intensive care units. MATERIALS AND METHODS: -values <0.05 were considered significant. RESULTS: Overall mortality in this cohort was 31%. Eighteen patients were followed up to an average age of 11.2 years. Of the 18 patients, 11 (61%) had a neurological impairment. Of the 15 surgically managed patients, 10 (67%) had an impairment and, of the 3 medically managed patients, 1 (33%) had an impairment. Cognitive impairment was the most common (10/18, 56%), followed by motor (6/18, 33%). Ten of 18 (56%) had special education needs, 9 of 18 (50%) had learning difficulties, 6 of 18 (33%) had speaking difficulties, and 4 of 18 (22%) had cerebral palsy. Patients also had behavioral conditions (3/18, 17%), visual impairment (2/18, 11%), and seizures (2/18, 11%). CONCLUSION: In the field of NEC, there is a hidden neurological burden that neonatal surgeons bequeath to the community. Sixty-one percent of patients are neurologically impaired, affecting the quality of life and function in the long-term. There should be appropriate parent counseling at the point of diagnosis and regular development checks for children with NEC.