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Article type: Research Article
Authors: Vongbhavit, K.a; b | Underwood, M.A.b; *
Affiliations: [a] Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon-Nayok, Thailand | [b] Department of Pediatrics, University of California Davis, Sacramento, CA, USA
Correspondence: [*] Address for correspondence: Mark A. Underwood, Division of Neonatology, 2516 Stockton Blvd, Sacramento, CA 95817, USA. Tel.: +1 916 734 5779; Fax: +1 916 456 2236; E-mail: [email protected].
Abstract: OBJECTIVE:To compare demographic data, prenatal and postnatal characteristics, laboratory data, and outcomes in a cohort of premature infants with spontaneous ileal perforation (SIP), surgical necrotizing enterocolitis (sNEC) and matched controls. METHODS:A retrospective case–control study of infants with intestinal perforation with a birth weight (BW) less than 2,000 grams and gestational age (GA) less than 34 weeks and infants without perforation matched for BW (±150 grams) and GA (±1week). RESULTS:130 premature infants were included, 30 infants with SIP, 35 infants with sNEC and 65 control infants. The median age of onset was 5 days postnatal age in SIP versus 25 days in sNEC (p < 0.001) and the peak onset was at 26 weeks corrected GA for SIP and 30 weeks corrected GA for sNEC. Infants with perforation had significantly higher rates of mortality (p < 0.001) and common morbidities associated with prematurity. Administration of corticosteroids and indomethacin did not differ among groups. SIP was more common among infants born to young mothers (p = 0.04) and less common in infants receiving caffeine (p = 0.02). sNEC was less common among infants receiving early red cell transfusion (p = 0.01). Perforation and sNEC trended towards less common in infants receiving inhaled nitric oxide. CONCLUSION:SIP and sNEC are distinct clinical entities. Potential protective effects of caffeine, inhaled nitric oxide, and early transfusion should be further studied.
Keywords: Necrotizing enterocolitis, spontaneous intestinal perforation, focal intestinal perforation, premature infant
DOI: 10.3233/NPM-16148
Journal: Journal of Neonatal-Perinatal Medicine, vol. 10, no. 3, pp. 281-289, 2017
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