Mortality and neurodevelopmental outcomes at 2 years’ corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study

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Butler, Victoria | Treluyer, Ludovic | Patkaï, Juliana | Biset, Aline | Jarreau, Pierre-Henri | Ancel, Pierre-Yves | Rozé, Jean-Christophe | Marchand-Martin, Laetitia | Durox, Mélanie | Lapillonne, Alexandre | Picaud, Jean-Charles | Mitanchez, Delphine | Tscherning, Charlotte | Biran, Valérie | Cambonie, Gilles | Lopez, Emmanuel | Hascoet, Jean-Michel | Desfrere, Luc | Chollat, Clément | Zana-Taïeb, Elodie | Torchin, Héloïse

Edité par CCSD ; Springer Verlag [1975-....] -

International audience. Purpose: The primary objective was to evaluate the impact of necrotising enterocolitis (NEC) and spontaneous intestinal perforation (SIP) on mortality and neurodevelopmental outcomes at 2 years' corrected age (CA) in infants born before 32 weeks' gestation (WG). Methods: We studied neurodevelopment at 2 years' CA of infants with NEC or SIP who were born before 32 WG from the EPIPAGE-2 cohort study. The primary outcome was death or the presence of moderate-to-severe motor or sensory disability defined by moderate-to-severe cerebral palsy or hearing or visual disability. The secondary outcome was developmental delay defined by a score < 2 SDs below the mean for any of the five domains of the Ages and Stages Questionnaire.Results: At 2 years' CA, 46% of infants with SIP, 34% of infants with NEC, and 14% of control infants died or had a moderate-to-severe sensorimotor disability (p < 0.01). This difference was mainly due to an increase in in-hospital mortality in the infants with SIP or NEC. Developmental delay at 2 years' CA was more frequent for infants with SIP than controls (70.8% vs 44.0%, p = 0.02) but was similar for infants with NEC and controls (49.3% vs 44.0%, p = 0.5). On multivariate analysis, the likelihood of developmental delay was associated with SIP (adjusted odds ratio = 3.0, 95% CI 1.0-9.1) but not NEC as compared with controls.Conclusion: NEC and SIP significantly increased the risk of death or sensorimotor disability at 2 years' CA. SIP was also associated with risk of developmental delay at 2 years' CA.

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