Noah Kinstlinger1, Adam Fink2, Sharon Gordon2, Terry L Levin2, Patricia Friedmann3, Suhas Nafday4, Mindy Statter5, Steven H Borenstein6. 1. Division of Pediatric Surgery, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, 10467 USA. 2. Division of Pediatric Radiology, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, 10467 USA. 3. Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, 10467 USA. 4. Division of Neonatology, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, 10467 USA. 5. Division of Pediatric Surgery, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, 10467 USA; Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, 10467 USA. 6. Division of Pediatric Surgery, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, 10467 USA; Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, 10467 USA. Electronic address: sborenst@montefiore.org.
Abstract
INTRODUCTION: Necrotizing enterocolitis predominantly affects preterm (PT) infants. The paucity of data regarding the clinical course in term infants makes it difficult to predict outcomes and counsel families. To identify predisposing factors and gain a better understanding of the clinical course of NEC in term infants, we reviewed our experience with term infants and compared it to outcomes in PT infants. METHODS: We performed a 10 year retrospective review of all infants admitted to our NICU with Bell stage 2 NEC or greater. Infants < 37 weeks gestation were considered PT. Term and PT infant comorbidities, outcomes and intraoperative findings were compared. RESULTS: Fifteen (12%) of 125 infants were term. Compared to PT infants, term infants were more likely to have congenital heart disease (33% term vs. 10% PT, p = 0.02) and develop NEC sooner (4 days in term vs. 17 days in PT, p < 0.001) but were less likely to require operative intervention (20% term vs. 38% PT; p = 0.17). There was no significant difference in Bell stage, survival and development of intestinal failure. NEC totalis occurred exclusively in PT infants. CONCLUSIONS: NEC in term infants has unique clinical features that distinguishes it from NEC in PT infants.
INTRODUCTION:Necrotizing enterocolitis predominantly affects preterm (PT) infants. The paucity of data regarding the clinical course in term infants makes it difficult to predict outcomes and counsel families. To identify predisposing factors and gain a better understanding of the clinical course of NEC in term infants, we reviewed our experience with term infants and compared it to outcomes in PT infants. METHODS: We performed a 10 year retrospective review of all infants admitted to our NICU with Bell stage 2 NEC or greater. Infants < 37 weeks gestation were considered PT. Term and PT infant comorbidities, outcomes and intraoperative findings were compared. RESULTS: Fifteen (12%) of 125 infants were term. Compared to PT infants, term infants were more likely to have congenital heart disease (33% term vs. 10% PT, p = 0.02) and develop NEC sooner (4 days in term vs. 17 days in PT, p < 0.001) but were less likely to require operative intervention (20% term vs. 38% PT; p = 0.17). There was no significant difference in Bell stage, survival and development of intestinal failure. NEC totalis occurred exclusively in PT infants. CONCLUSIONS: NEC in term infants has unique clinical features that distinguishes it from NEC in PT infants.
Authors: Gabriela Frid; Marina Reppucci; Tony Lum; Megan Paul; Howard Seiden; Brian A Coakley Journal: Front Pediatr Date: 2021-12-20 Impact factor: 3.418