ArticlePediatric research2024
Outcomes by disease onset, sex, and intervention in neonates with SIP and surgical NEC.
Article in Pediatric research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 12 citations in OpenAlex.
- Definitions of neonatal Necrotizing Enterocolitis (NEC) in randomised controlled trials: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- The role of abdominal ultrasound in surgical decision making for necrotizing enterocolitis.Journal of neonatal-perinatal medicine · 2026Review
- Nutritional management after necrotizing enterocolitis and focal intestinal perforation in preterm infants.Pediatric research · 2026Review
- Does the duration of empiric antibiotic treatment influence NEC incidence and severity relative to placental pathology?Journal of neonatal-perinatal medicine · 2026Review
- Does timing of surgery make the difference in outcomes for preterm infants with NEC?Pediatric research · 2026Review
- Risk Factors and Predictive Parameters of Necrotizing Enterocolitis in Preterm Infants-A Single-Center Retrospective Study.Diseases (Basel, Switzerland) · 2025Article
- Gut-Brain Axis in Preterm Infants with Surgical Necrotizing Enterocolitis.American journal of perinatology · 2025Review
- Laparotomy or peritoneal drain: Where does the evidence lead?Journal of neonatal-perinatal medicine · 2025Review
- Bedside Utilization of Intestinal Pathology in Preterm Infants with Surgical Necrotizing Enterocolitis.American journal of perinatology · 2025Review
- Association of timing of surgery and outcomes in preterm infants with surgical necrotizing enterocolitis and intestinal perforation.Journal of neonatal-perinatal medicine · 2024Article
- Clinical utilization of intestinal pathology in the classification of NEC vs SIP cases and prognostication.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Impact of sex, race, and social determinants of health on neonatal outcomes.Frontiers in pediatrics · 2024Review
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOutcomes of infants following surgical necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) categorized by the age of onset, interventions, and sex are not well defined.
methodsRetrospective comparison of infants categorized by age of onset (NEC at <10, 10-20, and >20 days) and SIP at <7 versus ≥7 days), sex, and intervention [Penrose Drain (PD) vs. laparotomy].
resultsA total of 114 infants had NEC and 37 had SIP. On multinomial logistic regression, infants with NEC/SIP onset >20 days had significantly lower odds of small bowel involvement (aOR = 0.07, 95% CI: 0.01-0.33, p = 0.001), higher necrosis (aOR = 3.59, 95% CI: 1.34-9.65, p = 0.012) and higher CRP (p = 0.004) than onset <10 days. Initial laparotomy was associated with more bowel loss (24.1 cm [12.3; 40.6] vs.12.1 [8.00; 23.2]; p = 0.001), small and large intestine involvement (47.1% vs 17.2%; p = 0.01), and ileocecal valve resection (42% vs. 19.4%; p = 0.036) than initial PD therapy. Females underwent fewer small bowel resections (52.3% vs 73.6%; p = 0.025) but had higher surgical morbidity (53.7% vs. 24.7%.; p = 0.001) than males.
conclusionClinical, radiological, and histopathological presentation and outcomes in preterm infants with surgical NEC/SIP are associated with age of disease onset, sex, and initial intervention. IMPACT: Neonates with surgical NEC onset >20 days had more severe necrosis, inflammation, kidney injury, and bowel loss than those with <10 days. Initial laparotomy was associated with later age onset, more bowel loss, and ileocecal valve resection compared to initial PD treatment, but not with differences in mortality or length of stay. Female sex was associated with lower maturity, more placental malperfusion, less often small bowel involvement, lower pre-NEC hematocrit as well as higher surgical morbidity than males. Whether the management of surgical NEC and SIP should differ by the age of onset requires further investigation.
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