Miriam Duci1, Anna Chiara Frigo2, Silvia Visentin3, Giovanna Verlato4, Piergiorgio Gamba1, Francesco Fascetti-Leon5. 1. Paediatric Surgery Unit, Women's and Children's Health Department, University of Padua, Padua, Italy. 2. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. 3. Department of Woman's and Child's Health, University of Padua, Padua, Italy. 4. Neonatal Intensive Care Unit, Women's and Children's Health Department, University of Padua, Padua, Italy. 5. Paediatric Surgery Unit, Women's and Children's Health Department, University of Padua, Padua, Italy. Electronic address: francesco.fascettileon@unipd.it.
Abstract
BACKGROUND/ PURPOSE: Antenatal factors play an important role in NEC. This study aimed to identify antenatal risk factors associated with the development of NEC, the role of the placental alterations, and the presence of prenatal signs predisposing to a severe NEC. MATERIALS/ METHODS: Data of NEC patients including antenatal findings [preeclampsia, diabetes, cholestasis, abnormal antenatal umbilical artery flow (AAUF), clinical chorioamnionitis (CC), and histology of placentas] were compared to unaffected cases between 2002 and 2016 in a single center. Unaffected infants were matched for gestational age. Newborns with cardiovascular diseases were excluded. Bivariate and multivariate analyses were performed. RESULTS: We identified 136 cases and 134 controls. The group of mothers of NEC-neonates had a higher prevalence of preeclampsia, CC, and AAUF. Histology of Placentas from 123/136 cases and 126/133 unaffected newborns was available. Chorioamnionitis was significantly more present in NEC cases vs controls. There weren't differences in vascular anomalies and necrotic alterations. Multivariate analysis identified AAUF, CC and histological chorioamnionitis (HC) as predictors of NEC. Bivariate tests show that preeclampsia and HC occurred more often in severe cases of NEC. CONCLUSION: This study suggests that AAUF, CC, and HC can independently predict the risk of NEC. Preeclampsia and HC seem associated to more severe cases. LEVEL OF EVIDENCE: IIIA.
BACKGROUND/ PURPOSE: Antenatal factors play an important role in NEC. This study aimed to identify antenatal risk factors associated with the development of NEC, the role of the placental alterations, and the presence of prenatal signs predisposing to a severe NEC. MATERIALS/ METHODS: Data of NEC patients including antenatal findings [preeclampsia, diabetes, cholestasis, abnormal antenatal umbilical artery flow (AAUF), clinical chorioamnionitis (CC), and histology of placentas] were compared to unaffected cases between 2002 and 2016 in a single center. Unaffected infants were matched for gestational age. Newborns with cardiovascular diseases were excluded. Bivariate and multivariate analyses were performed. RESULTS: We identified 136 cases and 134 controls. The group of mothers of NEC-neonates had a higher prevalence of preeclampsia, CC, and AAUF. Histology of Placentas from 123/136 cases and 126/133 unaffected newborns was available. Chorioamnionitis was significantly more present in NEC cases vs controls. There weren't differences in vascular anomalies and necrotic alterations. Multivariate analysis identified AAUF, CC and histological chorioamnionitis (HC) as predictors of NEC. Bivariate tests show that preeclampsia and HC occurred more often in severe cases of NEC. CONCLUSION: This study suggests that AAUF, CC, and HC can independently predict the risk of NEC. Preeclampsia and HC seem associated to more severe cases. LEVEL OF EVIDENCE: IIIA.
Authors: Peng Lu; Chhinder P Sodhi; Yukihiro Yamaguchi; William B Fulton; Sanxia Wang; Qinjie Zhou; Hongpeng Jia; Mark L Kovler; Andres Gonzalez Salazar; Maame Sampah; Thomas Prindle; Peter Wipf; David J Hackam Journal: Nat Commun Date: 2021-02-15 Impact factor: 14.919