Necrotizing enterocolitis (NEC) is a significant complication for premature newborns.
Infants who survive NEC are at increased risk of having poor long-term physiological and neurodevelopmental
growth. The objective of this paper is to give a comprehensive description of the
long-term consequences of NEC. Despite the rise in incidence of NEC there is a paucity of data regarding
long-term outcomes of these infants that can be divided into two groups.
The first group includes gastrointestinal complications that could occur in relation to the bowel disease,
the surgical treatment and quality of the residual bowel. These complications are strictures
and short bowel syndrome (SBS).
Intestinal strictures are a common occurrence after recovery from NEC that should be investigated
with a contrast study in case of suspicious clinical findings or before reversal ostomy. If the study
demonstrates a stricture in a symptomatic patient, resection with anastomosis is needed. SBS is the
result of a massive intestinal resection or of a dysfunctional residual bowel and it can occur in one
fourth of patients affected by NEC. The second group includes neurodevelopmental impairment
and growth. Neurodevelopmental outcomes in patients with NEC have not been widely reported.
Infants with NEC are at high risk for adverse neurodevelopmental outcomes whose cause can be
multifactorial and linked to perinatal events, severity of disease, surgical treatment and its complications
Understanding the morbidity of NEC with a long-term follow-up would aid neonatologists and pediatric
surgeons to make informed decisions in providing care for these patients. Further research
on this topic is needed.