Daniel J C Berkhout1,2, Patrick Klaassen2, Hendrik J Niemarkt3, Willem P de Boode4, Veerle Cossey5, Johannes B van Goudoever6,7, Christiaan V Hulzebos8, Peter Andriessen3, Anton H van Kaam9,10, Boris W Kramer11, Richard A van Lingen12, Daniel C Vijlbrief13, Mirjam M van Weissenbruch9, Marc Benninga1, Nanne K H de Boer14, Tim G J de Meij2. 1. Department of Pediatric Gastroenterology, Emma Children's Hospital / Academic Medical Center, Amsterdam, the Netherlands. 2. Department of Pediatric Gastroenterology, VU University Medical Center, Amsterdam, the Netherlands. 3. Neonatal Intensive Care Unit, Máxima Medical Center, Veldhoven, the Netherlands. 4. Neonatal Intensive Care Unit, Amalia Children's Hospital / Radboud University Medical Center, Nijmegen, the Netherlands. 5. Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium. 6. Department of Pediatrics, Emma Children's Hospital / Academic Medical Center, Amsterdam, the Netherlands. 7. Department of Pediatrics, VU University Medical Center, Amsterdam, the Netherlands. 8. Neonatal Intensive Care Unit, Beatrix Children's Hospital / University Medical Center Groningen, Groningen, the Netherlands. 9. Neonatal Intensive Care Unit, VU University Medical Center, Amsterdam, the Netherlands. 10. Neonatal Intensive Care Unit, Emma Children's Hospital / Academic Medical Center, Amsterdam, the Netherlands. 11. Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands. 12. Neonatal Intensive Care Unit, Amalia Children's Center / Isala, Zwolle, the Netherlands. 13. Neonatal Intensive Care Unit, Wilhelmina Children's Hospital / University Medical Center Utrecht, Utrecht, the Netherlands. 14. Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands.
Abstract
BACKGROUND: The identification of independent clinical risk factors for necrotizing enterocolitis (NEC) may contribute to early selection of infants at risk, allowing for the development of targeted strategies aimed at the prevention of NEC. OBJECTIVE: The objective of this study was to identify independent risk factors contributing to the development of NEC in a large multicenter cohort. METHODS: This prospective cohort study was performed in 9 neonatal intensive care units. Infants born at a gestational age ≤30 weeks were included. Demographic and clinical data were collected daily until day 28 postnatally. Factors predictive of the development of NEC were identified using univariate and multivariable analyses in a 1: 5 matched case-control cohort. RESULTS: In total, 843 infants (56 NEC cases) were included in this study. In the case-control cohort, univariate analysis identified sepsis prior to the onset of NEC and formula feeding to be associated with an increased risk of developing NEC, whereas the administration of antibiotics directly postpartum was inversely associated with NEC. In a multivariable logistic regression model, enteral feeding type and the number of days parenterally fed remained statistically significantly associated with NEC, whereas the administration of antibiotics directly after birth was associated with a lower risk of developing NEC. CONCLUSIONS: Formula feeding and prolonged (duration of) parenteral feeding were associated with an increased risk of NEC. Contrary to expectations, the initiation of treatment with antibiotics within 24 h after birth was inversely associated with NEC.
BACKGROUND: The identification of independent clinical risk factors for necrotizing enterocolitis (NEC) may contribute to early selection of infants at risk, allowing for the development of targeted strategies aimed at the prevention of NEC. OBJECTIVE: The objective of this study was to identify independent risk factors contributing to the development of NEC in a large multicenter cohort. METHODS: This prospective cohort study was performed in 9 neonatal intensive care units. Infants born at a gestational age ≤30 weeks were included. Demographic and clinical data were collected daily until day 28 postnatally. Factors predictive of the development of NEC were identified using univariate and multivariable analyses in a 1: 5 matched case-control cohort. RESULTS: In total, 843 infants (56 NEC cases) were included in this study. In the case-control cohort, univariate analysis identified sepsis prior to the onset of NEC and formula feeding to be associated with an increased risk of developing NEC, whereas the administration of antibiotics directly postpartum was inversely associated with NEC. In a multivariable logistic regression model, enteral feeding type and the number of days parenterally fed remained statistically significantly associated with NEC, whereas the administration of antibiotics directly after birth was associated with a lower risk of developing NEC. CONCLUSIONS: Formula feeding and prolonged (duration of) parenteral feeding were associated with an increased risk of NEC. Contrary to expectations, the initiation of treatment with antibiotics within 24 h after birth was inversely associated with NEC.
Authors: Sofia El Manouni El Hassani; Daniel J C Berkhout; Hendrik J Niemarkt; Sarah Mann; Willem P de Boode; Veerle Cossey; Christian V Hulzebos; Anton H van Kaam; Boris W Kramer; Richard A van Lingen; Johannes B van Goudoever; Daniel C Vijlbrief; Mirjam M van Weissenbruch; Marc A Benninga; Nanne K H de Boer; Tim G J de Meij Journal: Neonatology Date: 2019-04-04 Impact factor: 4.035
Authors: Deepak Selvakumar; Dolan Evans; Katharine Z Coyte; John McLaughlin; Andy Brass; Laura Hancock; Sheena Cruickshank Journal: Frontline Gastroenterol Date: 2022-06-15
Authors: Yanqi Li; René Liang Shen; Adejumoke I Ayede; Janet Berrington; Frank H Bloomfield; Olubunmi O Busari; Barbara E Cormack; Nicholas D Embleton; Johannes B van Goudoever; Gorm Greisen; Zhongqian He; Yan Huang; Xiaodong Li; Hung-Chih Lin; Jiaping Mei; Paula P Meier; Chuan Nie; Aloka L Patel; Per T Sangild; Thomas Skeath; Karen Simmer; Signe Uhlenfeldt; Marita de Waard; Sufen Ye; Xuqiang Ye; Chunyi Zhang; Yanna Zhu; Ping Zhou Journal: J Pediatr Date: 2020-06-14 Impact factor: 4.406