ReviewPediatric research2020
Intestinal dysbiosis and necrotizing enterocolitis: assessment for causality using Bradford Hill criteria.
Review in Pediatric research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Enteral Feeding Interventions in the Prevention of Necrotizing Enterocolitis: A Systematic Review of Experimental and Clinical Studies.Nutrients · 2021Pooled it
- A Paternal Fish Oil Diet Preconception Modulates the Gut Microbiome and Attenuates Necrotizing Enterocolitis in Neonatal Mice.Marine drugs · 2022Trial
- Compact Gut Microbial Dysbiosis Signature Associated with Necrotizing Enterocolitis and Altered Early Microbiota Development.Pathogens (Basel, Switzerland) · 2026Article
- The gut-lung axis in early life: microbiome-associated mechanisms and clinical relevance.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- The AhR-TLR4 axis in non-IgE-mediated Cow's milk allergy: a systematic review with integrated multi-omics corroboration.Frontiers in allergy · 2026Review
- Pathogenesis of necrotizing enterocolitis: mechanisms and mediators.World journal of pediatric surgery · 2026Review
- Role of gut microbiome in developing necrotizing enterocolitis.Folia microbiologica · 2025Article
- Placental abruption and the risk of necrotizing enterocolitis in neonates with birth weight ≥1500 grams; US national database study.Pediatric research · 2025Article
- Perinatal factors influencing the earliest establishment of the infant microbiome.Microbiome research reports · 2025Article
- Fresh Hemorrhages in Intestinal Resection Margins Are Associated with Unfavorable Clinical Outcomes in Preterm Infants with Necrotizing Enterocolitis with Surgical Intervention.Life (Basel, Switzerland) · 2024Article
- Mitigating Intestinal Dysbiosis in the Very Preterm Infant.Advances in nutrition (Bethesda, Md.) · 2024Article
- Article
- Role of innate T cells in necrotizing enterocolitis.Frontiers in immunology · 2024Review
- Role of the microbiome in pathophysiology of necrotising enterocolitis in preterm neonates.BMJ paediatrics open · 2023Review
- Time to first passage of meconium and defecation frequency preceding necrotizing enterocolitis in preterm infants: a case-control study.European journal of pediatrics · 2023Article
- The Nonbacterial Microbiome: Fungal and Viral Contributions to the Preterm Infant Gut in Health and Disease.Microorganisms · 2023Review
- Review
- Clinical and histopathological correlates of intestinal repair in preterm infants following surgical necrotizing enterocolitis.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2022Article
- Neonatal intermittent hypoxia, fish oil, and/or antioxidant supplementation on gut microbiota in neonatal rats.Pediatric research · 2022Article
- Longitudinal gut virome analysis identifies specific viral signatures that precede necrotizing enterocolitis onset in preterm infants.Nature microbiology · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
In recent years, several studies have shown that premature infants who develop NEC frequently display enteric dysbiosis with increased Gram-negative bacteria for several days to weeks prior to NEC onset. The importance of these findings, for the possibility of a causal role of these bacteria in NEC pathogenesis, and for potential value of gut dysbiosis as a biomarker of NEC, is well-recognized. In this review, we present current evidence supporting the association between NEC in premature infants and enteric dysbiosis, and its evaluation using the Bradford Hill criteria for causality. To provide an objective appraisal, we developed a novel scoring system for causal inference. Despite important methodological and statistical limitations, there is support for the association from several large studies and a meta-analysis. The association draws strength from strong biological plausibility of a role of Gram-negative bacteria in NEC and from evidence for temporality, that dysbiosis may antedate NEC onset. The weakness of the association is in the low level of consistency across studies, and the lack of specificity of effect. There is a need for an improved definition of dysbiosis, either based on a critical threshold of relative abundances or at higher levels of taxonomic resolution.
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Registered trials
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