Evidence map›Paper›PMID 34103675›Full record

ArticlePediatric research2022

Brain injury in preterm infants with surgical necrotizing enterocolitis: clinical and bowel pathological correlates.

Parvesh Mohan Garg, Jaslyn L Paschal, Mengna Zhang, Melissa Pippins, Abby Matthews, Kristin Adams, Charlotte Taylor, Kartik Reddy, Terrie E Inder, William B Hillegass

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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  9. Necrotizing enterocolitis.Nature reviews. Disease primers · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Parvesh Mohan GargDepartment of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA. gargparvesh@hotmail.com.ORCID http://orcid.org/0000-0001-5949-7304
Jaslyn L PaschalDepartment of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA.
Mengna ZhangDepartment of Data Science, University of Mississippi Medical Center, Jackson, MS, USA.
Melissa PippinsDepartment of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA.
Abby MatthewsDepartment of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA.
Kristin AdamsDepartment of Pathology, University of Mississippi Medical Center, Jackson, MS, USA.
Charlotte TaylorDepartment of Radiology, University of Mississippi Medical Center, Jackson, MS, USA.
Kartik ReddyDepartment of Radiology, University of Mississippi Medical Center, Jackson, MS, USA.
Terrie E InderDepartment of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
William B HillegassDepartment of Data Science, University of Mississippi Medical Center, Jackson, MS, USA.
Jackson Memorial Hospital · USBrigham and Women's Hospital · US

Funding

Tracking and Evaluation CoreU54GM115428 · NIGMS · UNIVERSITY OF MISSISSIPPI MED CTR · PI COMPRETTA, CAROLINE E. · 2016 to 2025
$38.2M
NIGMS NIH HHS U54 GM115428
6 · The paper itself

Abstract

backgroundThe objective of this study was to determine the risk factors and outcomes of white matter brain injury (WMBI) on magnetic resonance imaging (MRI) at term-equivalent age in infants with surgical necrotizing enterocolitis (NEC).

methodsThis retrospective study compared clinical/pathological information between infants with and those without WMBI.

resultsOut of 69 infants with surgical NEC, 17 (24.6%) had mild WMBI, 13 (18.8%) had moderate WMBI, and six (8.7%) had severe WMBI on the brain MRI. Several clinical factors (gestational age, more red blood cell (RBC) transfusions before NEC onset, pneumoperitoneum, earlier NEC onset age, postoperative ileus, acute kidney injury (AKI) by serum creatinine, postnatal steroids, hospital stay) and histopathological findings (necrosis, hemorrhage) had univariate associations with WMBI. Associations with RBC transfusion (odds ratio (OR) 23.6 [95% confidence interval (CI): 4.73-117.97]; p = 0.0001), age at NEC onset (OR 0.30 [95%CI: 0.11-0.84]; p = 0.021), necrosis (OR 0.10 [95%CI: 0.01-0.90]; p = 0.040), and bowel hemorrhage (OR 7.79 [95%CI: 2.19-27.72]; p = 0.002) persisted in multivariable association with grade 3-4 WMBI. The infants with WMBI had lower mean motor, cognitive, language scores, and higher ophthalmic morbidity at 2 years of age.

conclusionsThe WMBI was most likely associated with earlier NEC onset, higher RBC transfusions, and less necrosis and greater hemorrhage lesions on intestinal pathology in preterm infants with surgical NEC. IMPACT: In preterm infants with surgical NEC, brain MRI showed injury in the white matter in 52%, gray matter in 10%, and cerebellar region in 30%. Preterm infants with severe WMBI (grade 3-4) had less necrosis and greater hemorrhagic lesions on histopathology of the bowel. Preterm infants with WMBI were more likely to have a more severe postoperative course, AKI, and longer length of hospitalization. Neuroprotective strategies to prevent brain injury in preterm infants with surgical NEC are needed with the goal of improving the neurodevelopmental outcomes.

Indexed as

Acute Kidney InjuryBrain InjuriesEnterocolitis, NecrotizingFetal DiseasesInfant, Newborn, DiseasesFemaleHumansInfantInfant, NewbornInfant, PrematureNecrosisRetrospective StudiesRisk Factors

Identifiers

PMID34103675
PMCPMC10308193
OpenAlexW3166563696

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.