Long-term impact of necrotizing enterocolitis on somatosensory function in preterm born children.

BACKGROUND

Necrotizing enterocolitis (NEC) is a painful intestinal disease in preterm infants that causes severe prolonged pain requiring high amounts of analgesics. In a critical stage of neurodevelopment, pain and analgesics potentially impact sensory development. This study compared somatosensory function and sensory processing in preterm-born children with and without a history of NEC, as well as key self-/parent-reported outcomes.

METHODS

In this cross-sectional cohort study, preterm-born children (6-15 years old) with NEC were matched with controls. Each child underwent quantitative sensory testing in a mobile research lab at home. Parents completed questionnaires on their child's sensory processing, behavior, executive function, chronic pain, and (health-related) quality of life.

RESULTS

Sixty-six children (22 NEC, 44 control) participated. Children with a history of NEC exhibited lower cold pain thresholds (β = -11 °C, 95% CI [-21;-1.0], p = 0.03) compared to those without NEC. Moreover, they exhibited poorer executive function, though no longer significant after correcting for confounders. No significant differences were found in sensory processing, behavioral problems, chronic pain, and (health-related) quality of life.

CONCLUSION

Children with a history of NEC are less sensitive to cold pain, but have otherwise similar somatosensory function and sensory processing to other preterm-born children. Most self- and parent-reported outcomes are comparable to those of other preterm-born children without NEC.

IMPACT: Necrotizing enterocolitis in preterm infants lastingly alters their (cold) pain sensitivity. Most self- and parent-reported outcomes of children with a history of NEC are similar to those of other preterm-born children. Sensory processing and behavioral problems are common among both preterm-born children with and without NEC history. Our results warrant the search for protective strategies during NICU admission and thorough follow-up after NICU discharge.