Growth and neurodevelopmental outcome in extremely-low-birth-weight infants after laparotomy

Twenty-one extremely-low-birth-weight (ELBW) and premature infants (<29 wee ks' gestation and/or < 1,000 g) underwent emergency laparotomy for acute in tra-abdominal pathology (necrotising enterocolitis [NEC] 16, other bowel pa thology 5) during the 4-year period from 1990 to 1993; 11 died. The neurode velopmental outcome of the 10 survivors was assessed and compared with 20 l iving, otherwise normal controls matched for gestational age, birth weight, and year of birth to asses the effect of the abdominal event on quality of survival. Those who survived after laparotomy had a worse neurodevelopment al outcome than controls (P < 0.05). During this period, we also compared 2 4 infants in the ELBW category who developed NEC but did not require a lapa rotomy with the 16 ELBW infants with NEC who required a laparotomy. Those w ho required a laparotomy had worse disease and had significantly worse neur odevelopmental outcomes (P < 0.01). ELBW and premature infants who have acu te intra-abdominal pathology requiring a laparotomy are thus at increased r isk of neurodevelopmental problems and poor growth. Close longterm follow-u p is important, and the families of such infants should be made aware befor e surgery of the increased risk the abdominal event has on their babies' de velopmental outcome if they survive.