Risk of Necrotizing Enterocolitis and Feeding Interventions for Preterm Infants With Abnormal Umbilical Artery Doppler

Abstract

Infants exposed to absent or reversed end-diastolic flow (ARE DF) in utero may be at an increased risk of developing necrotizing enterocolitis (NEC). This article reviews placental function and the development of ARE DF. Studies examining the relationship between AREDF and NEC are reviewed, yet research remains inconclusive regarding this relationship. Recent studies reveal that early minimal enteral feeding does not increase the incidence of NEC in infants with AREDF. Initiation and advancement of enteral feedings should be monitored closely in this subset of the neonatal intensive care unit (NICU) population.

Feeding in Preterm Neonates With Antenatal Doppler Abnormalities: A Systematic Review and Meta-Analysis

“…These neonates are usually delivered preterm and small for gestational age (SGA). In the fetal life, they are exposed to chronic hypoxia leading to preferential shunting of blood to the brain at the expense of circulation to the gut (5). Pathophysiological studies have shown that prolonged prenatal hypoxia-ischemia of the gut results in in-utero injury and inflammation manifesting as NEC in the early neonatal period (6).…”

“…The relationship between the presence of antenatal Doppler abnormalities and the incidence of NEC is unclear (5). While earlier studies have reported increased NEC in neonates with antenatal Doppler abnormalities (7), more recent studies, have not observed an association between abnormal Doppler and increased incidence of NEC (4,8,9).…”