The majority of pediatric patients affected by intestinal failure (IF) develops this condition during the neonatal period.
To describe the natural course of IF with onset in neonatal age in order to give an actual estimation of its incidence and to provide a population based analysis about the spectrum of underlying diseases that can lead to IF.
We performed a retrospective chart review including all infants admitted to the neonatal intensive care unit (NICU) of 8 Italian tertiary Centers between January 1, 2003 and December 31, 2004. The definition of IF used for the study was the following (Guarino et al. J Pediatr Gastroenterol Nutr, 2003): a primary intestinal disease that induce the need of total parenteral nutrition (PN) for more than 4 weeks or the need of partial PN for more than 3 months.
The total number of live births during the study time within the enrolled Institutions was 50550, newborns admitted to the NICU was 5604. Twenty-six patients satisfied the definition of IF (birth weight 1753.1 ± 907.9 gr; gestational age 31.9 ± 4.2 wks) (mean ± 1 SD). The overall incidence of IF was 36.47 per 100.000 live births (95 % CI = 19.63; 53.31) and 4.63 per 1000 NICU admission (95 % CI = 2.85; 6.41). The aetiology of IF is showed in the table.
At 36 months follow-up, 88% of patients achieved intestinal sufficiency (median time for weaning from PN 58 days, range 32-163 days), two patients (7.7 %) were in home PN, one patient died.
IF represents a noteworthy issue for high risk newborns. To know the natural history of IF would be helpful to appropriately allocate resources and to plan clinical trials.