Chong, C;
Van Druten, J;
Briars, G;
Eaton, S;
Clarke, P;
Tsang, T;
Yardley, I;
(2019)
Neonates Living with Enterostomy Following Necrotising Enterocolitis are at High Risk of Becoming Severely Underweight.
European Journal of Pediatrics
, 178
(12)
pp. 1875-1881.
10.1007/s00431-019-03440-6.
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Abstract
Necrotising enterocolitis (NEC) is often managed with a temporary enterostomy. Neonates with enterostomy are at risk of growth retardation during critical neurodevelopment. We examined their growth using z-score. We identified all patients with enterostomy from NEC in two neonatal surgical units (NSU) during January 2012–December 2016. Weight-for-age z-score was calculated at birth, stoma formation and closure, noting severely underweight as z < − 3. We compared those kept in NSU until stoma closure with those discharged to local units or home (LU/H) with a stoma. A total of 74 patients were included. By stoma closure, 66 (89%) had deteriorated in z-score with 31 (42%) being severely underweight. There was no difference in z-score at stoma closure between NSU and LU/H despite babies sent to LU/H having a more distal stoma, higher birth weight and gestational age. Babies in LU/H spent a much shorter period on parenteral nutrition while living with their stoma for longer, many needing readmission. Conclusion: Growth failure is a common and severe problem in babies living with enterostomy following NEC. z-score allowed growth trajectory to be accounted for in nutrition prescription and timing of stoma closure. Care during this period should be focused on minimising harm.
| Type: | Article |
|---|---|
| Title: | Neonates Living with Enterostomy Following Necrotising Enterocolitis are at High Risk of Becoming Severely Underweight |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00431-019-03440-6 |
| Publisher version: | https://doi.org/10.1007/s00431-019-03440-6 |
| Language: | English |
| Additional information: | Copyright information © The Author(s) 2019. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| Keywords: | NEC, z-score, Stoma, Severe underweight, Growth failure, Intestinal failure |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10079787 |
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