Outcomes at 7 years for babies who developed neonatal necrotising enterocolitis: the ORACLE Children Study
Outcomes at 7 years for babies who developed neonatal necrotising enterocolitis: the ORACLE Children Study
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DOI：
10.1136/fetalneonatal-2011-300244
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发表时间：
2012-09-01
影响因子：
4.4
通讯作者：
Marlow, Neil
中科院分区：
文献类型：
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作者：
Pike, Katie;Brocklehurst, Peter;Marlow, Neil
背景 在 ORACLE 儿童研究队列中，作者评估了 7 岁时确诊或疑似新生儿坏死性小肠结肠炎 (NEC) 的长期后果。方法 使用家长调查问卷评估结果，包括用于评估功能障碍的健康效用指数 (HUI-3) 以及特定的医疗和行为结果。使用国家标准化测试探讨了英格兰儿童的教育成果。使用多元逻辑回归来探索队列中 NEC 的独立相关者。 结果 作者获得了 157 名经证实或疑似 NEC 的儿童中的 119 名 (77%) 的数据，并将他们的结果与其余 6496 名儿童的结果进行了比较。 NEC 与新生儿死亡风险增加相关（OR 14.6（95% CI 10.4 至 20.6））。 7 年时，NEC 增加了所有级别损伤的风险。调整混杂因素后，任何 HUI-3 定义的功能障碍（调整后 OR 1.55 (1.05, 2.29)）的风险仍然存在，特别是在所有 NEC 儿童和已证实 NEC 的儿童中轻度障碍（调整后 OR 1.61 (1.03, 2.53)），这似乎是独立的。没有证实行为或教育关联。 NEC 后，儿童比非 NEC 儿童更容易出现肠道问题（调整后 OR 3.96 (2.06, 7.61)）。 结论 ORACLE 儿童研究为对新生儿 NEC 后学龄结局进行最大规模的评估提供了机会，并证明了肠道功能（造口的存在、肠道问题入院以及肠道相关问题的持续医疗护理）和运动、感觉和认知结果（使用 HUI-3 测量）的显着长期后果。
Background Within the ORACLE Children Study Cohort, the authors have evaluated long-term consequences of the diagnosis of confirmed or suspected neonatal necrotising enterocolitis (NEC) at age of 7 years.Methods Outcomes were assessed using a parental questionnaire, including the Health Utilities Index (HUI-3) to assess functional impairment, and specific medical and behavioural outcomes. Educational outcomes for children in England were explored using national standardised tests. Multiple logistic regression was used to explore independent associates of NEC within the cohort.Results The authors obtained data for 119 (77%) of 157 children following proven or suspected NEC and compared their outcomes with those of the remaining 6496 children. NEC was associated with an increase in risk of neonatal death (OR 14.6 (95% CI 10.4 to 20.6)). At 7 years, NEC conferred an increased risk of all grades of impairment. Adjusting for confounders, risks persisted for any HUI-3 defined functional impairment (adjusted OR 1.55 (1.05, 2.29)), particularly mild impairment (adjusted OR 1.61 (1.03, 2.53)) both in all NEC children and in those with proven NEC, which appeared to be independent. No behavioural or educational associations were confirmed. Following NEC, children were more likely to suffer bowel problems than non-NEC children (adjusted OR 3.96 (2.06, 7.61)).Conclusions The ORACLE Children Study provided opportunity for the largest evaluation of school age outcome following neonatal NEC and demonstrates significant long-term consequences of both gut function (presence of stoma, admission for bowel problems and continuing medical care for gut-related problems) and motor, sensory and cognitive outcomes as measured using HUI-3.