Unexplained gut symptoms in extremely preterm infants are associated with gastrointestinal dysfunction at 5.5 years.

Aim: To evaluate whether extremely preterm infants with considerable gastrointestinal (GI) symptoms during the neonatal period, but without major abdominal surgery or necrotising enterocolitis, had an increased probability of developing GI dysfunction later in life.

Methods: A retrospective, case-control study on extremely preterm neonates that underwent an upper gastrointestinal contrast series (UGI) between 2012 and 2017, with UGI used as a marker of considerable GI symptoms. Controls were matched for sex and gestational age. The primary outcome was GI dysfunction requiring ongoing medical support at 5.5 years. Secondary outcomes included respiratory, neurological and growth abnormalities.

Results: Thirty-three patients and 66 controls were included; mean gestational age at birth was 25w + 4d. Cases had an odds ratio of 3.8 (p = 0.005; 95% CI = 1.47-9.82) for developing GI dysfunction at 5.5 years after adjusting for confounders. Neonatal morbidities of sepsis, patent ductus arteriosus and hypothyroidism were more common in cases (p < 0.05). No differences were seen in secondary outcomes at 5.5 years of age.

Conclusion: Extremely preterm infants with unexplained GI symptoms during the neonatal period had increased odds of developing GI dysfunction later in life, which was not explained by other morbidities. We suggest appropriate attention concerning later GI dysfunction in these patients.