Intestinal perforation in the premature infant

K. Vongbhavit, Mark Underwood

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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 languageEnglish (US)
Pages (from-to)281-289
Number of pages9
JournalJournal of Neonatal-Perinatal Medicine
Issue number3
StatePublished - 2017


  • focal intestinal perforation
  • Necrotizing enterocolitis
  • premature infant
  • spontaneous intestinal perforation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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