Antenatal umbilical Doppler abnormalities: an independent risk factor for early onset neonatal necrotizing enterocolitis in premature infants
Antenatal umbilical Doppler abnormalities: an independent risk factor for early onset neonatal necrotizing enterocolitis in premature infants
Background: necrotizing enterocolitis (NEC) is the most common gastrointestinal (GI) emergency seen in neonatal units. Many factors have been considered as potentially important aetiologically, including gut ischaemia, sepsis and feeding. However, evidence remains equivocal.
Objective: this study investigated whether preterm babies born to mothers with abnormal antenatal umbilical Dopplers (absent or reversed end diastolic flow - AREDF), that is exposed to antenatal gut ischaemia, are at an identical risk of developing NEC early in life, compared to babies born to mothers with normal Dopplers.
Methods: all preterm (≤32 + 6 week gestation) babies with no congenital anomaly, born to mothers resident in the county of Leicestershire in United Kingdom in 2001 and 2002 were identified using the Trent Neonatal Survey (TNS). Clinical data including the presence and severity of any NEC were extracted from the notes.
Results: two hundred forty-three preterm babies who met the criteria were identified during the period. Babies in whom umbilical Dopplers were not available and babies that died in the first 48 h were excluded. Complete data was thus available for 206 of these babies. A strong relation between AREDF and subsequent development of NEC was noted in these babies (OR: 5.88, 95% CI: 2.41 to 14.34, p < 0.0001). This association still held after adjustment for gestational age at birth (OR: 7.64, 95% CI: 2.96 to 19.70, p < 0.0001) and after adjustment for birthweight for gestational age z-score (OR: 6.72, 95% CI: 2.23 to 20.25, p = 0.0007).
Conclusions: this study, based on a neonatal cohort, indicates that AREDF is an important independent risk factor for the production of NEC.
Absent end diastolic flow, Antenatal Doppler flow, Neonatal necrotizing enterocolitis, Preterm, Reversal of end diastolic flow
327-331
Kamoji, V.M.
1209b95b-ebb1-4804-a644-a8cad31efe00
Dorling, J.S.
e55dcb9a-a798-41a1-8753-9e9ff8aab630
Manktelow, B.
004657a2-54f8-4bbf-97da-62bf471a3411
Draper, E.S.
942b15f0-37a5-4dfd-9d1a-bb3d62665491
Field, D.J.
92b4196a-0df1-4130-8ed7-3c6e08b9dcb6
19 February 2008
Kamoji, V.M.
1209b95b-ebb1-4804-a644-a8cad31efe00
Dorling, J.S.
e55dcb9a-a798-41a1-8753-9e9ff8aab630
Manktelow, B.
004657a2-54f8-4bbf-97da-62bf471a3411
Draper, E.S.
942b15f0-37a5-4dfd-9d1a-bb3d62665491
Field, D.J.
92b4196a-0df1-4130-8ed7-3c6e08b9dcb6
Kamoji, V.M., Dorling, J.S., Manktelow, B., Draper, E.S. and Field, D.J.
(2008)
Antenatal umbilical Doppler abnormalities: an independent risk factor for early onset neonatal necrotizing enterocolitis in premature infants.
Acta Paediatrica, 97 (3), .
(doi:10.1111/j.1651-2227.2008.00671.x).
Abstract
Background: necrotizing enterocolitis (NEC) is the most common gastrointestinal (GI) emergency seen in neonatal units. Many factors have been considered as potentially important aetiologically, including gut ischaemia, sepsis and feeding. However, evidence remains equivocal.
Objective: this study investigated whether preterm babies born to mothers with abnormal antenatal umbilical Dopplers (absent or reversed end diastolic flow - AREDF), that is exposed to antenatal gut ischaemia, are at an identical risk of developing NEC early in life, compared to babies born to mothers with normal Dopplers.
Methods: all preterm (≤32 + 6 week gestation) babies with no congenital anomaly, born to mothers resident in the county of Leicestershire in United Kingdom in 2001 and 2002 were identified using the Trent Neonatal Survey (TNS). Clinical data including the presence and severity of any NEC were extracted from the notes.
Results: two hundred forty-three preterm babies who met the criteria were identified during the period. Babies in whom umbilical Dopplers were not available and babies that died in the first 48 h were excluded. Complete data was thus available for 206 of these babies. A strong relation between AREDF and subsequent development of NEC was noted in these babies (OR: 5.88, 95% CI: 2.41 to 14.34, p < 0.0001). This association still held after adjustment for gestational age at birth (OR: 7.64, 95% CI: 2.96 to 19.70, p < 0.0001) and after adjustment for birthweight for gestational age z-score (OR: 6.72, 95% CI: 2.23 to 20.25, p = 0.0007).
Conclusions: this study, based on a neonatal cohort, indicates that AREDF is an important independent risk factor for the production of NEC.
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More information
Accepted/In Press date: 26 November 2007
e-pub ahead of print date: 19 February 2008
Published date: 19 February 2008
Keywords:
Absent end diastolic flow, Antenatal Doppler flow, Neonatal necrotizing enterocolitis, Preterm, Reversal of end diastolic flow
Identifiers
Local EPrints ID: 485030
URI: http://eprints.soton.ac.uk/id/eprint/485030
ISSN: 0803-5253
PURE UUID: a312f3d3-6528-438d-988f-ccbd8818b995
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Date deposited: 28 Nov 2023 17:50
Last modified: 18 Mar 2024 04:16
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Contributors
Author:
V.M. Kamoji
Author:
J.S. Dorling
Author:
B. Manktelow
Author:
E.S. Draper
Author:
D.J. Field
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