Elena Palleri1, Ida Aghamn2, Tomas S Bexelius3, Marco Bartocci4, Tomas Wester5. 1. Department of Women and Children's Health, Karolinska Institute, Elevhemmet, H2:00, Karolinska University Hospital, 17176, Stockholm, Sweden; Department of Neonatology, Astrid Lindgren Children's Hospital, 17176, Stockholm, Sweden. Electronic address: elena.palleri@ki.se. 2. Department of Advanced Pediatric In-home care, Astrid Lindgren Children's Hospital, 17176, Stockholm, Sweden. 3. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, 17177, Stockholm, Sweden. 4. Department of Women and Children's Health, Karolinska Institute, Elevhemmet, H2:00, Karolinska University Hospital, 17176, Stockholm, Sweden; Department of Neonatology, Astrid Lindgren Children's Hospital, 17176, Stockholm, Sweden. 5. Department of Women and Children's Health, Karolinska Institute, Elevhemmet, H2:00, Karolinska University Hospital, 17176, Stockholm, Sweden; Department of Pediatric Surgery, Astrid Lindgren Children's Hospital, 17176, Stockholm, Sweden.
Abstract
BACKGROUND/ PURPOSE: To test the hypothesis that clinical and radiological features of necrotizing enterocolitis vary with gestational age in all neonates with NEC and in subgroup of surgically treated patients. METHODS: This was a retrospective study case series. NEC cases treated in Stockholm County from 2009 to 2014 were identified in the National Quality Register. Patients were included in the study if they had a verified NEC diagnosis and they were divided into 2 groups according to the gestational age. RESULTS: A total of 89 patients were included. Of these 60 (67.4%) neonates had a gestational age <28 and 29 (32.6%) infants ≥28weeks. Surgical NEC patients were 57 (64%). Pneumatosis intestinalis at the abdominal radiographs was noted significantly more often in neonates born at ≥28weeks of gestation (86.2%) compared to extremely preterm newborns (60.0%). Neonates born at ≥28weeks of gestation presented more often bloody stools (58.6%) compared to extremely preterm newborns (20.0%). In surgical NEC patients gasless abdomen was detected in 35.6% of the neonates born <28weeks compared to 6.7% of the more mature neonates. CONCLUSIONS: Extremely preterm neonates with NEC show less specific clinical and radiological signs of NEC compared to more mature neonates. This suggests that Bell's classification is not adequate for the diagnosis and staging of NEC in extremely preterm neonates. LEVEL OF EVIDENCE: III.
BACKGROUND/ PURPOSE: To test the hypothesis that clinical and radiological features of necrotizing enterocolitis vary with gestational age in all neonates with NEC and in subgroup of surgically treated patients. METHODS: This was a retrospective study case series. NEC cases treated in Stockholm County from 2009 to 2014 were identified in the National Quality Register. Patients were included in the study if they had a verified NEC diagnosis and they were divided into 2 groups according to the gestational age. RESULTS: A total of 89 patients were included. Of these 60 (67.4%) neonates had a gestational age <28 and 29 (32.6%) infants ≥28weeks. Surgical NEC patients were 57 (64%). Pneumatosis intestinalis at the abdominal radiographs was noted significantly more often in neonates born at ≥28weeks of gestation (86.2%) compared to extremely preterm newborns (60.0%). Neonates born at ≥28weeks of gestation presented more often bloody stools (58.6%) compared to extremely preterm newborns (20.0%). In surgical NEC patients gasless abdomen was detected in 35.6% of the neonates born <28weeks compared to 6.7% of the more mature neonates. CONCLUSIONS: Extremely preterm neonates with NEC show less specific clinical and radiological signs of NEC compared to more mature neonates. This suggests that Bell's classification is not adequate for the diagnosis and staging of NEC in extremely preterm neonates. LEVEL OF EVIDENCE: III.
Authors: Pontus Challis; Linn Larsson; Elisabeth Stoltz Sjöström; Fredrik Serenius; Magnus Domellöf; Anders Elfvin Journal: Acta Paediatr Date: 2018-10-09 Impact factor: 2.299
Authors: Julia M Pantalone; Silvia Liu; Oluwabunmi O Olaloye; Erica C Prochaska; Toby Yanowitz; Melissa M Riley; Justin R Buland; Beverly S Brozanski; Misty Good; Liza Konnikova Journal: Front Pediatr Date: 2021-02-26 Impact factor: 3.418