Long-term outcomes of very low birth weight infants with spontaneous intestinal perforation: A retrospective case-matched cohort study.

Abstract

BACKGROUND\nSpontaneous intestinal perforation (SIP) is an intestinal complication that occurs in very ill preterms. We investigated whether SIP survivors have worse neurodevelopmental and gastrointestinal outcomes and a poorer quality of life than controls.\n\n\nMETHODS\nA retrospective case-matched cohort study was performed involving infants treated for SIP in a NICU between August 1994 and April 2014. Controls and SIP patients were matched to gestational age, gender, and birth period. Medical records were reviewed. Telephone surveys were conducted to evaluate the medical condition, quality of life (PedsQL™ 4.0), neuropsychiatric and gastrointestinal outcome. McNemar s and Wilcoxon tests were performed, and generalized linear models were computed.\n\n\nRESULTS\nForty-nine SIP patients were included. The percentages of children with multiple disabilities (40% vs. 17%, OR\u202f=\u202f3.3) and requiring physiotherapy (86% vs. 60%, OR\u202f=\u202f4.77) were higher in the SIP group than in the control group. Intraventricular hemorrhage (IVH) led to a worse neurodevelopmental outcome regardless of SIP (OR\u202f=\u202f8.79 for disability), and female gender was a protective factor against disability (OR\u202f=\u202f0.06). Reported quality of life and gastrointestinal comorbidities did not differ between the two groups.\n\n\nCONCLUSION\nSIP survivors tend to be at risk of multiple disabilities. IVH and female gender influence the neurodevelopmental outcome regardless of SIP.\n\n\nLEVELS OF EVIDENCE\nLevel III: case-control study.