ArticleBMC gastroenterology2025
Gestational age-dependent clinical characteristics of necrotizing enterocolitis-associated intestinal perforation: a 10-year cohort study.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo delineate gestational age (GA)-dependent pathophysiology of necrotizing enterocolitis-associated intestinal perforation (NEC-IP) and establish precision management protocols.
methodsA single-center retrospective cohort study (2013-2023) included 66 preterm (< 37 weeks) and 38 term (≥ 37 weeks) neonates with NEC-associated perforations. Outcomes included anatomical distribution, microbiological profiles, management disparities, and prognoses.
resultsPreterm infants exhibited significantly higher rates of twin gestation (43.9% vs 7.9%, p = 0.003), antenatal steroid exposure (43.9% vs 2.6%, p < 0.001), and preoperative fasting rate (33.3% vs 7.9%, p = 0.009) compared to term infants. Preterm infants demonstrated Gram-positive bacteremia (83.3%) with Gram-negative peritoneal predominance (83.9%), alongside significantly lower leukocyte counts (Stage 2:12.6 vs 14.9 × 10⁹/L, Stage 3: 9.1 vs 11.1 × 10⁹/L, both p < 0.05), platelet levels (all stage), and hemoglobin levels (Stage 1:125.1 vs 141.6 × 10
conclusionGA-specific NEC-IP mechanisms mandate: (1) preterm-focused ileal exploration & Gram-negative coverage, (2) term-focused retroperitoneal debridement & Gram-positive control, and (3) GA-stratified diagnostic framework integrating clinical signs and imaging. This precision approach reduces missed perforations and surgical delays.
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