Clinical and histopathological correlates of intestinal repair in preterm infants following surgical necrotizing enterocolitis

Garg, Parvesh Mohan; Middleton, Charles E.; Zhang, Mengna; Paschal, Jaslyn L.; Kurundkar, Ashish; Sonani, Hardik; Varshney, Neha; Hillegass, William B.

doi:10.1080/14767058.2022.2134773

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…Necrotizing enterocolitis is associated with necrosis, inflammation, hemorrhage, and reparative changes on intestinal histopathological examination [4]. The hemorrhagic necrosis seen in infants with NEC is likely due to abnormal vasculature and neoangiogenesis in the intestine [5,6]. The retinopathy of prematurity is also associated with abnormal vascularization secondary to insulin-like growth factor 1 (IGF-1) and vascular endothelial growth factor (VEGF) mediated effects on retinal angiogenesis [7].…”

Section: Introductionmentioning

confidence: 99%

“…4 The hemorrhagic necrosis seen in infants with NEC is likely due to abnormal vasculature and neoangiogenesis in the intestine. 5,6 The retinopathy of prematurity (ROP) is also associated with abnormal vascularization secondary to insulin-like growth factor 1 (IGF-1)-and vascular endothelial growth factor (VEGF)mediated effects on retinal angiogenesis. 7 In the Early Treatment for Retinopathy of Prematurity study, ROP developed in 68% of preterm infants < 1,251 g, and severe ROP developed in almost 37% of those cases.…”

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confidence: 99%

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Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation

Garg,

Riddick,

Ansari

et al. 2024

Am J Perinatol

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Objective: This study aimed to identify the clinical and growth parameters associated with retinopathy of prematurity (ROP) in infants with necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP). Methods: We conducted a retrospective cohort study that compared clinical data before and after NEC/SIP onset in neonates, categorizing by any ROP and severe ROP (Type 1/2) status. Results: The analysis included one hundred and nine infants (n=109) with surgical necrotizing enterocolitis/SIP. Sixty infants (60/109, 55%) were diagnosed with any ROP, 32/109 (29.3%) infants (22% Types 1 and 7.3% Type 2) with severe ROP. On univariate analysis, those with severe ROP(32/109, 39.5%) were of lower median gestational age (23.8 weeks [23.4;24.6] vs. 27.3 [26.3;29.], p=<0.001), lower median birth weight (625 grams [512;710] vs.935 [700;1180]; p<0.001) and experienced higher exposure to clinical chorioamnionitis (22.6% vs. 2.13%; p=<0.006), and later median onset of ROP diagnosis (63.0 days [47.0;77.2] vs. 29.0 [19.0;41.0]; p=<0.001), received Penrose drain placement more commonly (19 (59.4%) vs.16 (34.0%); p=0.04), retained less residual small bowel (70.0 cm [63.1;90.8] vs.90.8 [72.0;101]; p=0.007) following surgery, were exposed to higher FiO2 seven days after birth (p=0.001), received ventilation longer and exposed to higher FiO2 at two weeks (p <0.05) following NEC and developed acute kidney injury (AKI) more often (25 (86.2%) vs.20 (46.5%); p= 0.002) than those without ROP. Those with severe ROP had lower length, weight for length, and head circumference z scores. In an adjusted Firth’s logistic regression, GA (aOR=0.51, 95% CI: [0.35, 0.76]) and diagnosis at later age (aOR=1.08, 95% CI: [1.03, 1.13]) was shown to be significantly associated with any ROP. Conclusion: Infants who develop severe ROP following surgical NEC/SIP are likely to be younger, smaller, have been exposed to more O2, develop AKI, and grow poorly compared to those did not develop severe ROP.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation

Garg,

Riddick,

Ansari

et al. 2024

Am J Perinatol

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“…Necrotizing enterocolitis is associated with necrosis, in ammation, hemorrhage and reparative changes on intestinal histopathological examination [3]. The hemorrhagic necrosis seen in infants with NEC is most likely due to anormal vasculature and neo angiogenesis in the intestine [4,5]. The Retinopathy of prematurity is also associated with abnormal vascularization because of insulin like growth factor 1 (IGF-1) and vascular endothelial growth factor (VEGF) effect on the retinal angiogenesis [6].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm infants with Surgical Necrotizing Enterocolitis and intestinal Perforation

Riddick,

Meilstrup,

Ansari

et al. 2023

Preprint

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Background: we sought to determine the clinical and growth parameters associated with retinopathy of prematurity (ROP) in infants with necrotizing enterocolitis (NEC) and spontaneous ileal perforation (SIP). Methods: Retrospective cohort study comparing clinical information before and following NEC/SIP onset in neonates with and without severe ROP (Type 1 and 2). Results: Those with severe ROP (32/109, 39.5%) had lower GA, BW, chorioamnionitis, later median onset of ROP diagnosis and received Penrose drain and had higher AKI, poor weight z scores, poor linear growth, longer duration of ventilation and higher FIo2 than those without ROP following NEC/SIP. The GA and diagnosis at later age remained significant for any ROP on multi regression modelling. Conclusion: The surgical NEC/SIP infants with severe ROP were more likely to be younger, smaller, had AKI, had higher oxygen exposure and poor weight gain and linear growth than those without severe ROP.

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Probiotics for Preventing Necrotizing Enterocolitis: A Meta-Analysis with Trial Sequential Analysis

Zhang

et al. 2023

Journal of Clinical Pharmacy and Therapeutics

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What is Known and Objective. The role of probiotics, especially the different genera of probiotics, in managing necrotizing enterocolitis (NEC) is controversial. Thus, we performed a meta-analysis with trial sequential analysis (TSA) to determine the efficacy and safety of probiotics for preventing NEC. Methods. Medline, Embase, CENTRAL, WorldCat, TROVE, DART-Europe, and CBM were searched from inception to May 2022. Two investigators independently screened the literature, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4, and TSA was conducted using TSA 0.9 beta. Results and Discussion. Fifty-five studies involving 12897 newborns were eligible. The use of probiotics for preventing NEC reduced the incidence of NEC (RR 0.48, 95% CI 0.41 to 0.57, and P < 0.05) and sepsis (RR 0.77, 95% CI 0.64 to 0.94, and P < 0.05), the risk of mortality (RR 0.69, 95% CI 0.58 to 0.84, and P < 0.05), and shortened the average days of hospitalization (MD −3.12, 95% CI −4.98 to −1.26, and P < 0.05). However, subgroup analysis revealed that different genera of probiotics gave rise to different outcomes. In addition, TSA indicated that the cumulative z-curve crossed the traditional and trial sequential monitoring boundaries for benefit, providing firm evidence that multiple strains and Lactobacillus species of probiotics decreased the incidence of NEC. However, the current evidence was inconclusive for Bifidobacterium and Saccharomyces species. What is New and Conclusions. Probiotics are effective in preventing NEC and sepsis and could provide added benefits, including decreasing mortality and the number of days of hospitalization. However, considering the heterogeneity of probiotics regimens and the risk of selective reporting of RCTs, more high-quality clinical trials targeting different genera of probiotics with suitable doses and timing to prophylactic use of probiotics are needed to avoid overestimating the role of probiotics in preterm infants.

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Clinical and histopathological correlates of intestinal repair in preterm infants following surgical necrotizing enterocolitis

Cited by 3 publications

References 26 publications

Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation

Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation

Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm infants with Surgical Necrotizing Enterocolitis and intestinal Perforation

Probiotics for Preventing Necrotizing Enterocolitis: A Meta-Analysis with Trial Sequential Analysis

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