Short- and Long-Term Morbidities in Preterm Infants with Necrotizing Enterocolitis or Spontaneous Intestinal Perforation

다국어 초록 (Multilingual Abstract)

Purpose: This study compared short-term morbidity, mortality, and long-term neurological outcomes among preterm infants with necrotizing enterocolitis (NEC) and those with spontaneous intestinal perforation (SIP).
Methods: We conducted a retrospective analysis using data collected between 2013 and 2023 from the Korean Neonatal Network. The study included preterm infants born at <32 weeks of gestation or with a birth weight of <1,500 g who were diagnosed with NEC or SIP. A total of 18,446 infants were classified into four groups: control, medical NEC, surgical NEC, and SIP.
Results: Short-term morbidities and mortality were most prevalent in the surgical NEC group, whereas hypotension was most prevalent in the SIP group. Post hoc analysis showed that bronchopulmonary dysplasia and intraventricular hemorrhage were more common in the surgical NEC group than in the SIP group. Compared with the control and medical NEC groups, the surgical NEC group had significantly higher rates of hypotension, seizures, periventricular leukomalacia, sepsis, and retinopathy of prematurity but did not differ significantly from the SIP group. The surgical NEC and SIP groups required a longer time to achieve full enteral feeding, longer duration of total parenteral nutrition, and longer hospital stay. At a corrected age of 18–24 months, cerebral palsy and vision loss were more common in the surgical NEC group. At 33–39 months, cerebral palsy and eye disorders were more prevalent in the surgical NEC group, whereas hearing outcomes were worse in the SIP group.
Conclusion: Surgical NEC was associated with the poorest short- and long-term outcomes in preterm infants, and SIP showed comparable outcomes.