Bone Abstracts

Objectives: Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease, mainly affecting preterm infants. NEC-survivors may have short or dysfunctional bowel with malnutrition as a result. Osteopenia of prematurity is well described among preterm infants. To the best of our knowledge there are no studies that follow preterm NEC-survivors to 5 years of age, regarding growth and bone mass. The aim was to study whether children diagnosed with NEC during their neonatal period are shorter and have lower bone mineral content (BMC) and bone mineral density (BMD) at 5 years of age, compared to matched no-NEC-controls.

Methods: In this pilot longitudinal follow-up study a total of 36 children at age 5 years were included. The 18 NEC-patients had been medically or surgically treated for NEC during their neonatal period at Queen Silvia Children’s Hospital, Gothenburg, Sweden. To every case a no-NEC-control matched for gestational age and gender, was included. Height and weight were measured at follow-up. Bone mass was measured by Dual-energy X-ray absorptiometry (DXA). Information from hospital charts regarding the neonatal period, and surgical data, was collected. Data were evaluated using Mann-Whitney U test. Statistical significance was assumed at P<0.05.

Results: The NEC-children were significantly shorter (P<0.05), had lower weight (P<0.001) and lower BMI (P<0.05) at 5 years of age compared to no-NEC-controls. Total body less head (TBLH) BMC were significantly lower among NEC-children (P<0.001). Regarding TBLH BMD, no significant differences were found. TBLH BMD Z-scores ranged from −2.5 to +0.4 S.D. for cases and from −1.5 to +2.2 S.D. for controls, (P=0.052). The NEC-children had significantly lower lumbar spine (L1-L4) BMC (P<0.05), BMD (P< 0.05) and BMD Z-score (P<0.05).

Conclusion: Children with NEC during their neonatal period were shorter, had lower body weight, a decreased TBLH BMC, and a lower lumbar spine BMD than no-NEC-controls at 5 years of age. NEC-survivors are at increased risk of osteopenia and growth disturbance during childhood, however there may be confounding factors related to other morbidities during the neonatal period and further longitudinal studies are warranted.

Disclosure: The authors declared no competing interests.