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 correctedGAfor SIP and 30 weeks correctedGAfor 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). sNECwas 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 281-289 |
| Number of pages | 9 |
| Journal | Journal of Neonatal-Perinatal Medicine |
| Volume | 10 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2017 |
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Keywords
- focal intestinal perforation
- Necrotizing enterocolitis
- premature infant
- spontaneous intestinal perforation
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Intestinal perforation in the premature infant. / Vongbhavit, K.; Underwood, Mark.
In: Journal of Neonatal-Perinatal Medicine, Vol. 10, No. 3, 2017, p. 281-289.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intestinal perforation in the premature infant
AU - Vongbhavit, K.
AU - Underwood, Mark
PY - 2017
Y1 - 2017
N2 - 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 correctedGAfor SIP and 30 weeks correctedGAfor 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). sNECwas 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.
AB - 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 correctedGAfor SIP and 30 weeks correctedGAfor 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). sNECwas 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.
KW - focal intestinal perforation
KW - Necrotizing enterocolitis
KW - premature infant
KW - spontaneous intestinal perforation
UR - http://www.scopus.com/inward/record.url?scp=85031823237&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85031823237&partnerID=8YFLogxK
U2 - 10.3233/NPM-16148
DO - 10.3233/NPM-16148
M3 - Article
C2 - 28854518
AN - SCOPUS:85031823237
VL - 10
SP - 281
EP - 289
JO - Journal of Neonatal-Perinatal Medicine
JF - Journal of Neonatal-Perinatal Medicine
SN - 1934-5798
IS - 3
ER -