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Abstract：
Necrotizing enterocolitis (NEC) is associated with significant morbidity and mortality in preterm infants. Early recognition and treatment of NEC are critical to improving outcomes. Enteric nervous system (ENS) immaturity has been proposed as a key factor in NEC pathophysiology. Gastrointestinal dysmotility is associated with ENS immaturity and may serve as a predictive factor for the development of NEC. In this case-control study, preterm infants (gestational age (GA) < 30 weeks) were included in two level-IV neonatal intensive care units. Infants with NEC in the first month of life were 1:3 matched to controls based on GA (± 3 days). Odds ratios for NEC development were analyzed by logistic regression for time to first passage of meconium (TFPM), duration of meconial stool, and mean daily defecation frequency over the 72 h preceding clinical NEC onset (DF < T0). A total of 39 NEC cases and 117 matched controls (median GA 27 + 4 weeks) were included. Median TFPM was comparable in cases and controls (36 h [IQR 13-65] vs. 30 h [IQR 9-66], p = 0.83). In 21% of both cases and controls, TFPM was ≥ 72 h (p = 0.87). Duration of meconial stool and DF < T0 were comparable in the NEC and control group (median 4 and 3, resp. in both groups). Odds of NEC were not significantly associated with TFPM, duration of meconial stools, and DF < T0 (adjusted odds ratio [95% confidence interval]: 1.00 [0.99-1.03], 1.16 [0.86-1.55] and 0.97 [0.72-1.31], resp.).
CONCLUSIONS: In this cohort, no association was found between TFPM, duration of meconium stool, and DF < T0 and the development of NEC.
BACKGROUND: • Necrotizing enterocolitis (NEC) is a life-threatening acute intestinal inflammatory disease of the young preterm infant. Early clinical risk factors for NEC have been investigated in order to facilitate early diagnosis and treatment. • Signs of disrupted gastrointestinal mobility, such as gastric retention and paralytic ileus, have been established to support the diagnosis of NEC. Nevertheless, defecation patterns have insufficiently been studied in relation to the disease.
BACKGROUND: • Defecation patterns in the three days preceding NEC did not differ from gestational age-matched controls of corresponding postnatal age. Additionally, the first passage of meconium and the duration of meconium passage were comparable between cases and controls. Currently, defecation patterns are not useful as early warning signs for NEC. It remains to be elucidated whether these parameters are different based on the location of intestinal necrosis.
CONCLUSIONS: In this cohort, no association was found between TFPM, duration of meconium stool, and DF < T0 and the development of NEC.
BACKGROUND: • Necrotizing enterocolitis (NEC) is a life-threatening acute intestinal inflammatory disease of the young preterm infant. Early clinical risk factors for NEC have been investigated in order to facilitate early diagnosis and treatment. • Signs of disrupted gastrointestinal mobility, such as gastric retention and paralytic ileus, have been established to support the diagnosis of NEC. Nevertheless, defecation patterns have insufficiently been studied in relation to the disease.
BACKGROUND: • Defecation patterns in the three days preceding NEC did not differ from gestational age-matched controls of corresponding postnatal age. Additionally, the first passage of meconium and the duration of meconium passage were comparable between cases and controls. Currently, defecation patterns are not useful as early warning signs for NEC. It remains to be elucidated whether these parameters are different based on the location of intestinal necrosis.
摘要：
坏死性小肠结肠炎（NEC）与早产儿的高发病率和死亡率相关。NEC的早期识别和治疗对于改善结果至关重要。肠神经系统（ENS）不成熟已被认为是NEC病理生理学的关键因素。胃肠动力障碍与ENS不成熟有关，可能是NEC发展的预测因素。在这项病例对照研究中，将早产儿(胎龄(GA)<30周)纳入两个IV级新生儿重症监护病房.基于GA(±3天),在生命的第一个月中患有NEC的婴儿与对照1:3匹配。通过对胎粪首次传代时间（TFPM）的逻辑回归分析NEC发育的几率，中途大便的持续时间，临床NEC发病前72小时的平均每日排便频率（DF结论：在这个队列中，没有发现TFPM之间的关联，胎粪的持续时间，和DF背景：•坏死性小肠结肠炎（NEC）是年轻早产儿的一种危及生命的急性肠道炎性疾病。为了促进早期诊断和治疗，已经研究了NEC的早期临床危险因素。•胃肠道活动中断的迹象，如胃潴留和麻痹性肠梗阻，已建立以支持NEC的诊断。然而，排便模式尚未得到充分研究。
背景：•NEC前3天的排便模式与相应出生后年龄的胎龄匹配对照没有差异。此外,胎粪的首次通过和胎粪通过的持续时间在病例和对照组之间是相当的。目前,排便模式不能作为NEC的早期预警信号。这些参数是否基于肠坏死的位置而不同，还有待阐明。
背景：•NEC前3天的排便模式与相应出生后年龄的胎龄匹配对照没有差异。此外,胎粪的首次通过和胎粪通过的持续时间在病例和对照组之间是相当的。目前,排便模式不能作为NEC的早期预警信号。这些参数是否基于肠坏死的位置而不同，还有待阐明。
