Evidence map›Paper›PMID 40341253›Full record

ArticlePediatric research2025

Early antibiotic exposure and necrotizing enterocolitis among preterm infants < 34 weeks' gestation.

Yue Zhu, Shujuan Li, Siyuan Jiang, Weiyin Yu, Yongfu Yu, Zhenlang Lin, Xiaoying Li, Huiqing Sun, Yan Mo, Yihuang Huang and 7 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

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

  1. Pooled it
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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

17 authors.

Yue Zhu *Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.
Shujuan Li *Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Siyuan JiangDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Weiyin YuDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Yongfu YuDepartment of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
Zhenlang LinDepartment of Neonatology, The 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China.
Xiaoying LiDepartment of Neonatology, Children's Hospital Affiliated to Shandong University, Shandong, China.
Huiqing SunDepartment of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Children's Hospital of Henan Zhengzhou, Henan, China.
Yan MoNeonatal Medical Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, The Children's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China.
Yihuang HuangDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Luyang HongDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Joseph Y TingDepartment of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Shoo K LeeUniversity of Toronto, Toronto, ON, Canada.
Zhiping LiDepartment of Clinical Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
Weibing WangDepartment of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.
Yun CaoDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China. yuncao@fudan.edu.cn.
Reduction of Infection in Neonatal Intensive Care Units using the Evidence-based Practice for Improving Quality (REIN-EPIQ) Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo investigate whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis (NEC) among preterm infants born at <34 weeks' gestation.

methodsThis multicenter prospective cohort study included all infants with gestational age <34 weeks and admitted to neonatal intensive care units across China. Early antibiotic exposure was defined as the antibiotic treatment initiated within the first three postnatal days. The short-term outcomes included death, NEC, death and/or NEC. Propensity score matching was performed to generate matched cohorts. The impacts of early antibiotics exposure on the outcomes were evaluated by univariate and multivariate logistic regression models.

resultsAmong 24,926 eligible infants, 20164 (80.9%) received early antibiotics. After matching, early antibiotics exposure was not significantly associated with the death and/or NEC (adjusted OR, 0.93; 95%CI, 0.72-1.21), NEC (adjusted OR, 0.81; 95% CI, 0.60 -1.10) or death (adjusted OR, 1.42; 95% CI, 0.90-2.25). However, prolonged antibiotic treatment (adjusted OR, 2.95; 95% CI, 1.67-5.22), especially broad-spectrum antibiotics exposure (adjusted OR, 5.09; 95% CI, 1.84-14.10), was independently associated with death.

conclusionWhile early antibiotics exposure was not associated with the risks of NEC, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality. IMPACT: This multicenter cohort study sheds light on whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis among preterm infants <34 weeks of gestation. In preterm infants, early antibiotics exposure was not significantly associated with the risks of death and/or NEC. However, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality. Our study emphasizes the importance of neonatal antimicrobial stewardship in improving the prognosis of premature infants.

Indexed as

Anti-Bacterial AgentsEnterocolitis, NecrotizingInfant, Premature, DiseasesChinaFemaleGestational AgeHumansInfant, NewbornInfant, PrematureIntensive Care Units, NeonatalLogistic ModelsMalePropensity ScoreProspective StudiesRisk FactorsTime FactorsAnti-Bacterial Agents

Identifiers

PMID40341253

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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.