Clinical characteristic comparison of low birth weight and very low birth weight preterm infants with neonatal necrotizing enterocolitis: a single tertiary center experience from eastern China

Lin, Huang; Mao, Shanshan; Shi, Liping; Tou, Jinfa; Du, Lizhong

doi:10.1007/s00383-018-4339-9

Cited by 7 publications

(7 citation statements)

References 36 publications

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“…Due to the poor blood circulation, shock is prone to occur. [21] The abdominal aortic blood reflux occurs during diastole, resulting in insufficient intestinal blood flow and the mesentery in a hypoxic-ischemic state. [22] The high levels of TNF-α and IL-3 in children with congenital heart disease are also a factor that causes intestinal wall damage.…”

Section: Discussionmentioning

confidence: 99%

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The predictors of necrotizing enterocolitis in newborns with low birth weight

Tan¹,

Zhou²,

Xu³

et al. 2022

Medicine

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There are needs to investigate the influencing factors of necrotizing enterocolitis (NEC) in low birth weight (LBW) newborns, to provide insights into the clinical management of NEC.This study was a retrospective cohort study. Infants admitted to our hospital from January 1, 2019 to June 30, 2021 were selected. The clinical characteristics of NEC and no-NEC infants were evaluated. Logistic regression analyses were conducted to assess the risk factors of NEC in LBW infants.A total of 192 LBW infants were included, the incidence of NEC in LBW infants was 35.42%. There were significant differences in the congenital heart disease, sepsis, breastfeeding, blood transfusion and probiotics feeding between NEC and no-NEC group (all P < .05), and there were no significant differences in birth weight, gestational age, mother's pregnancy-induced hypertension, premature rupture of fetal membrane, amniotic fluid pollution, fetal asphyxia, neonatal respiratory distress syndrome and mechanical ventilation between NEC and no-NEC group (all P > .05). Congenital heart disease (OR: 2.128, 95% CI: 1.103–3.511), sepsis (OR: 1.630, 95% CI: 1.022–2.549), and blood transfusion (OR: 1.451, 95% CI: 1.014–2.085) were the independent risk factors for NEC in LBW infants, and breastfeeding (OR: 0.494, 95% CI: 0.023–0.928), probiotics feeding (OR: 0.816, 95% CI: 0.782–0.982) were the protective factors for the NEC in LBW infants. The prognosis of NEC infants undergone surgery treatment was better than that of infants undergone conservative treatments (P = .043).The incidence of NEC in LBW is high, which is affected by many factors, and comprehensive interventions targeted on the risk and protective factors should be made to improve the prognosis of LBW infants.

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Section: Discussionmentioning

confidence: 99%

“…Congenital heart disease can affect the blood flow of the intestinal tract. Due to the poor blood circulation, shock is prone to occur [21] . The abdominal aortic blood reflux occurs during diastole, resulting in insufficient intestinal blood flow and the mesentery in a hypoxic-ischemic state [22] .…”

Section: Discussionmentioning

confidence: 99%

The predictors of necrotizing enterocolitis in newborns with low birth weight

Tan¹,

Zhou²,

Xu³

et al. 2022

Medicine

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“…It may affect both full-term and preterm neonates with the latter group having an increased risk. Predisposing factors include prematurity, low birth weight, formula feeding, intrauterine growth retardation, postnatal asphyxia, sepsis, and congenital heart diseases ( 41 , 42 ). In NEC, bowel inflammation causes necrosis and perforation which may lead to intestinal surgical removal, death or a lifetime severe neurodevelopmental impairment ( 43 , 44 )…”

Section: Mscs For the Treatment Of Neonatal Gut Diseasesmentioning

confidence: 99%

The Potential of Mesenchymal Stromal Cell as Therapy in Neonatal Diseases

et al. 2020

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Mesenchymal stromal cells (MSCs) can be derived from various tissue sources, such as the bone marrow (BMSCs), adipose tissue (ADSCs), umbilical cord (UC-MSCs) and umbilical cord blood (UCB-MSCs). Clinical trials have been conducted to investigate the potential of MSCs in ameliorating neonatal diseases, including bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC). In preclinical studies, MSC therapy has been tested for the treatment of various neonatal diseases affecting the heart, eye, gut, and brain as well as sepsis. Up to date, the number of clinical trials using MSCs to treat neonatal diseases is still limited. The data reported thus far positioned MSC therapy as safe with positive outcomes. However, most of these trials are still preliminary and generally smaller in scale. Larger trials with more appropriate controls and a longer follow-up period need to be conducted to prove the safety and efficacy of the therapy more conclusively. This review discusses the current application of MSCs in treating neonatal diseases, its mechanism of action and future direction of this novel therapy, including the potential of using MSC-derived extracellular vesicles instead of the cells to treat various clinical conditions in the newborn.

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“…The occurring frequency of NEC is close to 7% in very-low-birth-weight infants, and their mortality rates reach one-third. Surgical intervention is done in approximately 20%–40% of NEC infants ( 3 ). Also, NEC infants undergoing surgery may experience worse outcomes such as short bowel syndrome and neurodevelopmental dysplasia ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Alteration of the gut microbiota after surgery in preterm infants with necrotizing enterocolitis

Lin

Xu²,

Chen

et al. 2023

Front. Pediatr.

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PurposeTo investigate the dynamic changes in the intestinal microbiota in preterm infants with necrotizing enterocolitis (NEC) before and after treatment via a prospective case-control study.MethodsPreterm infants with NEC and preterm infants with similar age and weight (control group) were enrolled in this study. They were divided into NEC_Onset (diagnosis time), NEC_Refeed (refeed time), NEC_FullEn (full enteral nutrition time), Control_Onset, and Control_FullEn groups according to the time of the fecal material collected. Except for basic clinical information, fecal specimens of the infants were obtained as well at indicated times for 16S rRNA gene sequencing. All infants were followed up after discharge from the NICU, and the growth data of the corrected age of 12 months were acquired from the electronic outpatient system and telephonic interviews.ResultsA total of 13 infants with NEC and 15 control infants were enrolled. A gut microbiota analysis showed that the Shannon and Simpson indices were lower in the NEC_FullEn group than in the Control_FullEn group (p < .05). Methylobacterium, Clostridium_butyricum, and Acidobacteria were more abundant in infants with NEC during diagnosis. Methylobacterium and Acidobacteria were remained plentiful in the NEC group until the end of treatment. These bacteria species were significantly positively correlated with CRP and negatively correlated with platelet count. The rate of delayed growth was higher in the NEC group than in the control group (25% vs. 7.1%) at 12 months of corrected age, but there was no significant difference. In addition, the pathways of synthesis and degradation of ketone bodies were more active in the NEC subgroups, including both the NEC_Onset group and the NEC_FullEn group. The pathway of sphingolipid metabolism was more active in the Control_FullEn group.ConclusionEven after reaching the full enteral nutrition period, alpha diversity in infants with NEC who underwent surgery was lower than that in the control group infants. It may take more time to reestablish the normal gut flora of NEC infants after surgery. The pathways of the synthesis and degradation of ketone bodies and sphingolipid metabolism might be related to the pathogenesis of NEC and physical development after the occurrence of NEC.

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Clinical characteristic comparison of low birth weight and very low birth weight preterm infants with neonatal necrotizing enterocolitis: a single tertiary center experience from eastern China

Cited by 7 publications

References 36 publications

The predictors of necrotizing enterocolitis in newborns with low birth weight

The predictors of necrotizing enterocolitis in newborns with low birth weight

The Potential of Mesenchymal Stromal Cell as Therapy in Neonatal Diseases

Alteration of the gut microbiota after surgery in preterm infants with necrotizing enterocolitis

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