New Strategies for Necrotizing Enterocolitis Diagnosis and Prevention in Newborns

Perrone, Serafina; Cremonini, Isabella; Marinelli, Francesca; Nicoletti, Laura; Giordano, Maurizio; Esposito, Susanna

doi:10.2174/1573396317666210426102610

Cited by 9 publications

(5 citation statements)

References 76 publications

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“…CRP levels rise sharply in response to infection and trauma, and whole-blood CRP levels are widely used to assess various types of inflammatory responses. Studies ( 9 , 10 ) have shown that PCT, CRP, and IL-6 levels in patients with stage III NEC are significantly higher than those in patients with stage I–II and thus may serve as a benchmark for choosing a surgical option for NEC.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of serum markers in the operation evaluation of neonatal necrotizing enterocolitis

Wang¹,

Jin²,

Su³

et al. 2023

Transl Pediatr

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Background Neonatal necrotizing enterocolitis (NEC) is a common gastrointestinal emergency in newborns. Currently, the pathogenesis of the disease remains unknown. This study aims to determine the application value of serum markers in the selection of operation opportunities for NEC. Methods This study consisted of a retrospective analysis of the clinical data of 150 participants with NEC admitted to Maternal and Child Health Hospital of Hubei Province from March 2017 to March 2022. Participants were assigned to an operation group (n=58) and a nonoperation group (n=92) according to the presence or absence of surgical treatment. Serum sample data for serum C-reactive protein (CRP) and interleukin 6 (IL-6), serum amyloid A (SAA), procalcitonin (PCT), and intestinal fatty acid-binding protein (I-FABP) concentrations were estimated. To compare the differences in overall data and serum markers between the 2 groups, independent factors related to surgical treatment in pediatric patients with NEC were analyzed using logistic regression. The utility of serum markers in selecting surgical options in pediatric patients with NEC was analyzed by constructing a receiver operating characteristic (ROC) curve. Results CRP, I-FABP, IL-6, PCT, and SAA levels were higher in the operation group than in the nonoperation group (P<0.05). Multivariate logistic regression analysis confirmed that CRP, I-FABP, IL-6, PCT, and SAA were independent related factors of NEC surgical remedy (P<0.05). Meanwhile, ROC curve analysis yielded a serum CRP, PCT, IL-6, I-FABP, and SAA area under curve (AUC) of NEC operation timing of 0.805, 0.844, 0.635, 0.872, and 0.864, respectively; a sensitivity of 75.90%, 86.20%, 60.30%, 82.80%, and 84.50%, respectively; and a specificity of 80.40%, 79.30%, 68.35%, 80.40%, and 80.55%, respectively. Conclusions The serum markers CRP, PCT, IL-6, I-FABP, and SAA have certain guiding values in the choice of operation opportunity for pediatric patients with NEC.

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Section: Introductionmentioning

confidence: 99%

Predictive value of serum markers in the operation evaluation of neonatal necrotizing enterocolitis

Wang¹,

Jin²,

Su³

et al. 2023

Transl Pediatr

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“…It primarily affects the ileum, jejunum, and/or colon, making it a significant condition [2] . It is characterized by submucosal edema, infiltration of immune cells (especially neutrophils) in the intestinal wall, and intestinal perforation due to necrosis of the intestinal wall in severe cases [3] . The pathogenesis of NEC is not fully understood.…”

Section: Introductionmentioning

confidence: 99%

A novel two-stage deep learning model used to assist in diagnosing neonatal necrotizing enterocolitis and determining the need for surgical treatment

Qi,

Ding,

et al. 2023

Preprint

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Background and Aims: Neonatal necrotizing enterocolitis (NEC) is a common life-threatening gastrointestinal disease in newborns. Abdominal X-rays (AXRs) is an important basis for diagnosing NEC and determining the need for surgical treatment. Computer-aided diagnosis (CAD) is extensively utilized in the clinical diagnosis of numerous diseases. Nevertheless, the efficacy of CAD for NEC has not been widely validated. Methods: We proposed for the first time a two-stage multimodal classification method for NEC based on AXRs data. The objective is to achieve early diagnosis of NEC and determine the optimal timing for surgical intervention. This method addresses the problem of insufficient labeled data through transfer learning and introduces coordinate attention to enhance the accuracy of target region localization and identification, thereby improving the capability of image feature extraction. Results: In total, the dataset was sourced from 2 children’s hospital consisted of 3,176 AXRs from 845 newborns diagnosed with NEC. Additionally, there were 1,825 AXRs from 470 newborns without NEC. The task for determining whether newborns has NEC achieved an accuracy of 97.49%, recall of 97.44%, precision of 83.09%, F1-score of 98.02% and AUC of 99.68%. Similarly, for the task of identifying if NEC patients require surgery, the accuracy, recall, precision, and F1-score were 78.96%, 81.50%, 80.30%, 80.89%, and 84.49% respectively. Our method performed better than the four commonly used baseline methods in the two-stage NEC diagnosis task. Conclusions: We have introduced a novel two-stage diagnostic model for NEC in newborns, which can rapidly and accurately identify NEC patients and determine if surgery is necessary.

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“…Ischemic factors, feeding with hyperosmolar mixtures, malabsorption, forced amounts of food, and bacterial flora lead to the damage of the intestinal mucosa [4,5]. In NEC, in almost all cases, there are factors of social, medical-organizational, and medical-biological nature, which are either a cause or an aggravating situation for the occurrence of NEC and fatalities [3,6]. In connection with the abovementioned, the task was set to prove the significance of the combinations of these factors for a reliable study of the incidence rate.…”

Section: Introductionmentioning

confidence: 99%

“…Other researchers consider hypotension during the week of life as an independent risk factor for the development of NEC, as circulatory disorders during this period of life can lead to impaired gastrointestinal blood flow, and, consequently, to a high incidence of necrosis [6,8,9].…”

Section: Introductionmentioning

confidence: 99%

Importance of Combinations of Risk Factors in the Development of Necrotizing Enterocolitis in Newborn Children

Ismayilova¹

2022

Ukr. ž. med. bìol. sportu

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The purpose of the study was to identify factors of increased risk of necrotizing enterocolitis among young children in Baku. Materials and methods. Two observation groups were selected: the main observation group – children with necrotizing enterocolitis (128 children), the control observation group – healthy children (64 children). The children of the main group were divided into 2 groups: group 1 (n=83) – children with necrotizing enterocolitis who were treated conservatively and had no complications; group 2 (n=45) – children with necrotizing enterocolitis who had purulent-inflammatory complications and were treated surgically. In the course of the study, anamnestic and clinical laboratory research methods were used. Results and discussion. A relatively high percentage of women aged 19–29 years and 30–39 years was established – 63.2 ± 4.3 and 20.3 ± 3.5%, respectively, in the main group of children, and 75.0 ± 5.4 and 14.0 ± 4.3% in the control group. In families of children born with necrotizing enterocolitis, 38.3% of mothers assessed their material and living conditions as unsatisfactory (p<0.01). It was revealed that the proportion of children with postnatal risk factors: < 1500 g of body weight at birth among children of the main group (63.2 ± 4.3%) is by 5 times more than among children of the control group (12.5 ± 4.2%, p<0.05). It was also found that the proportion of children with respiratory disorders significantly differs from each other in the compared groups (22.6 ± 3.6 and 3.2 ± 2.1%, respectively, p<0.05). The proportion of children who were administered artificial enteral nutrition with milk formula among children of the main group (75.0 ± 3.8%) was by 9.6 times higher than among children of the control group (7.8 ± 3.3%, p<0.001). The results of our study also coincide with the results of the authors, who revealed a relationship with the course of pregnancy, childbirth, and necrotizing enterocolitis. Conclusion. The results of the study showed that the most pronounced risk of necrotizing enterocolitis incidence is expected at the birth of children weighing 1500 g or less (prematurity of degrees 3–4), and usually such children predominate among newborns whose mothers were not observed by obstetrician-gynecologists in the antenatal period and, therefore, did not receive adequate treatment. Background medical and biological factors can be called such as the age of the mother, the state of health of the woman (the presence of genital and extragenital diseases) and the course of pregnancy (gestosis in combination with various pathologies)

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New Strategies for Necrotizing Enterocolitis Diagnosis and Prevention in Newborns

Cited by 9 publications

References 76 publications

Predictive value of serum markers in the operation evaluation of neonatal necrotizing enterocolitis

Predictive value of serum markers in the operation evaluation of neonatal necrotizing enterocolitis

A novel two-stage deep learning model used to assist in diagnosing neonatal necrotizing enterocolitis and determining the need for surgical treatment

Importance of Combinations of Risk Factors in the Development of Necrotizing Enterocolitis in Newborn Children

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