Evidence map›Paper›PMID 39955429›Full record

Trial reportPediatric research2025

Effect of early antibiotic exposure on necrotizing enterocolitis and growth in extremely preterm infants.

Katie M Strobel, Thomas R Wood, Gregory C Valentine, Olivia C Brandon, D Taylor Hendrixson, Dennis E Mayock, Krystle M Perez, Mihai Puia-Dumitrescu, Patrick J Heagerty, Sandra E Juul

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
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.

Katie M StrobelDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA. kmstrob@uw.edu.ORCID http://orcid.org/0000-0002-7717-0425
Thomas R WoodDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Gregory C ValentineDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Olivia C BrandonDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
D Taylor HendrixsonDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Dennis E MayockDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Krystle M PerezDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Mihai Puia-DumitrescuDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Patrick J HeagertyDepartment of Biostatistics, University of Washington, Seattle, WA, USA.
Sandra E JuulDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe relationship between early antibiotic exposure, necrotizing enterocolitis (NEC), and growth faltering (GF) in extremely preterm infants is unknown.

methodsWe evaluated the association between peripartum and postnatal antibiotic exposure in the first week after birth with NEC and GF in this secondary analysis of Preterm Erythropoietin Neuroprotection Trial subjects. NEC was defined as Bell's stage ≥ IIA; GF was defined as decreased weight, length, or head circumference (HC) z-score from birth to discharge of < -0.8. Multivariable analyses were adjusted with maternal and infant factors.

resultsA total of 891 infants survived the first week and were included in the NEC analyses, while 828 infants survived to discharge and were included in the growth analyses. For every 1-day increase in infant antibiotic exposure during the first week after birth, there was a significantly increased adjusted hazard of NEC (aHR/day 1.14 [1.01-1.28], p = 0.034). Antibiotics for 3-4 days and 5-7 days total in the first week were associated with increased odds of weight GF (aOR 1.90 [1.21-2.99], aOR 2.32 [1.44-3.74]), length GF (aOR 1.76 [1.22-2.59], aOR 1.88 [1.26-2.80]), and HC GF (aOR 1.75 [1.08-2.84], aOR 1.87 [1.14-3.08]).

conclusionIncreased antibiotic exposure in the first week after birth was associated with NEC and GF risk. IMPACT: In this post-hoc analysis of a large multi-site trial, we found infant antibiotic exposure in the first week after birth was associated with an increased hazard of necrotizing enterocolitis in the extremely preterm infant after adjusting for maternal and infant factors. First week antibiotic exposure in the extremely preterm infant was associated with an increased odds of weight, linear, and head circumference growth faltering after adjusting for maternal and infant factors. These findings encourage the judicious use of early antibiotics in extremely preterm infants.

Indexed as

Anti-Bacterial AgentsEnterocolitis, NecrotizingInfant, Extremely PrematureFemaleGestational AgeHumansInfant, NewbornMaleRisk FactorsSecondary Data AnalysisTime FactorsAnti-Bacterial Agents

Identifiers

PMID39955429

What OpenQuestion holds

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Registered trials

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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.