Very Low Birth Weight Premature Infants are at Higher Risk of Dying With Short Bowel Syndrome

January 1st, 2009 by Dr. Jae H. Kim (MD, PhD, FRCPC, FAAP)

One of the nation’s largest premature infant databases (NICHD) has been examined to determine the risks of dying for infants with short bowel syndrome or SBS. SBS is a devastating condition where a significant portion of an infant’s small and large bowel are removed due to damage or dysfunction. Subsequently, the infant is not able to be supported nutritionally with their own bowel and require long-term intravenous nutrition. As expected from most neonatal experiences, the biggest contributor of SBS is necrotizing enterocolitis (NEC, 96%). In this study the investigators found that very low birth weight infants (less than 1500 grams at birth) who had surgical NEC were at higher risk of dying in hospital than if they had NEC without surgery (also called medical NEC) or compared to all infants with SBS. They found an overall incidence of SBS of 0.7%. They also found that the risk of dying was the highest in infant who had surgery because of NEC (53%). When they examined the outcomes of the survivors, they found that those with SBS were more likely to be small and poorly grown and this included smaller head sizes. It is important to remember that head size correlates well with long-term brain development. This study underlines the ongoing burden of the consequences of NEC on both mortality and morbidity.

Very Low Birth Weight Preterm Infants With Surgical Short Bowel Syndrome: Incidence, Morbidity and Mortality, and Growth Outcomes at 18 to 22 Months Conrad R. Cole and colleagues, for the Eunice Kennedy Shriver NICHD Neonatal Research Network, Pediatrics. 2008 Sep;122(3):e573-82.

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