UNASSIGNED: This was a retrospective case-control study of neonates born <33 weeks gestational age (GA) who were admitted to a tertiary neonatal intensive care unit, between 2015 and 2018. NEC-III cases were compared with Stage-II NEC (NEC-II) and non-NEC controls. Two to four non-NEC controls were matched by GA ± 1 week and date of birth ± 3 months, to one NEC-III case. Univariate and multivariate analyses were used to examine risk factors for NEC-III.
UNASSIGNED: Of 1360 neonates born <33 weeks, 71 (5.2%) had NEC-II and above, with 46% being NEC-III. Mean age of onset of NEC-III was 13.7 days versus 23.9 days for NEC-II (p = 0.01). Neonates with NEC-III were of lower GA (NEC-III 25.4 weeks, NEC-II 27.3 weeks, and non-NEC 26 weeks; p = 0.0008) and had higher Score for Neonatal Acute Physiology Perinatal Extension-II scores (NEC-III 47.5, NEC-II 28.4 and non-NEC 37, p = 0.003). Multivariate analysis showed duration of umbilical arterial catheter (UAC) >5 days was significantly associated with the development of NEC-III with adjusted odds ratio (AOR) 3.8; 95% confidence interval (CI) (1.05-13.66) for NEC-III versus non-NEC and AOR 5.57; 95% CI (1.65-18.73), p = 0.006 for NEC-III versus NEC-II. Rupture of membranes (ROM) >1 week was associated with NEC-III (AOR 6.93; 95% CI [1.56-30.69] vs. non-NEC and AOR 11.74; 95% CI [1.14-120.34] vs. NEC-II).
UNASSIGNED: The increased association of NEC-III with duration of UAC and ROM could be further examined in prospective studies, and an upper limit for UAC duration could be considered in NEC prevention bundles.
这是一项回顾性病例对照研究,研究对象是出生在胎龄<33周龄(GA)的新生儿入住三级新生儿重症监护病房,2015年至2018年。将NEC-III病例与II期NEC(NEC-II)和非NEC对照进行比较。2至4名非NEC对照按GA±1周和出生日期±3个月进行匹配,一个NEC-III案件。使用单变量和多变量分析来检查NEC-III的危险因素。
■1360名出生<33周的新生儿中,71人(5.2%)拥有NEC-II及以上,46%是NEC-III。NEC-III的平均发病年龄为13.7天,而NEC-II的平均发病年龄为23.9天(p=0.01)。患有NEC-III的新生儿的GA较低(NEC-III25.4周,NEC-II27.3周,和非NEC26周;p=0.0008),并且在新生儿急性生理学围产期延伸-II评分方面得分较高(NEC-III47.5,NEC-II28.4和非NEC37,p=0.003)。多变量分析显示,脐动脉导管(UAC)>5天的持续时间与NEC-III的发展显着相关,调整比值比(AOR)3.8;NEC-III与非NEC和AOR的95%置信区间(CI)(1.05-13.66)5.57;95%CI(1.65-18.73),对于NEC-III与NEC-II,p=0.006。膜破裂(ROM)>1周与NEC-III相关(AOR6.93;95%CI[1.56-30.69]vs.非NEC和AOR11.74;95%CI[1.14-120.34]与NEC-II)。
■可以在前瞻性研究中进一步检查NEC-III与UAC和ROM持续时间的相关性。UAC持续时间的上限可以在NEC预防束中考虑。