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Abstract：
UNASSIGNED: To explore risk factors for Stage-III necrotizing enterocolitis (NEC-III) in preterm neonates.
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.
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.
摘要：
■探讨早产儿III期坏死性小肠结肠炎（NEC-III）的危险因素。
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。
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。
