Evidence map›Paper›PMID 41703485›Full record

Observational studyBMC pregnancy and childbirth2026

Association between initial empirical antibiotic therapy and necrotizing enterocolitis in very preterm infants at different risk for early-onset sepsis: a multicenter cohort study.

Zhenyu Li, Jie Yang, Xinyue Gu, Yanhong Li, Yinquan Xu, Wenhao Zhou, Yun Cao, Shoo K Lee, Hui Wu, Chinese Neonatal Network

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC pregnancy and childbirth, 2026. 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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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Zhenyu Li *Department of Neonatology, Children's Medical Center, The First Hospital of Jilin University, NO.1 Xinmin Street, Changchun, 130021, Jilin, China.
Jie Yang *NHC Key Laboratory of Neonatal Diseases, Children's Hospital of Fudan University, Shanghai, China.
Xinyue GuNHC Key Laboratory of Neonatal Diseases, Children's Hospital of Fudan University, Shanghai, China.
Yanhong LiDepartment of Neonatology, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, China.
Yinquan XuDepartment of Neonatology, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, China.
Wenhao ZhouGuangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
Yun CaoDivision of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Shoo K LeeDepartment of Pediatrics, University of Toronto, Toronto, ON, Canada.
Hui WuDepartment of Neonatology, Children's Medical Center, The First Hospital of Jilin University, NO.1 Xinmin Street, Changchun, 130021, Jilin, China. wuhui@jlu.edu.cn.
Chinese Neonatal Network

Funding

CIHR CTP87518National Natural Science Foundation of China 82271737
6 · The paper itself

Abstract

backgroundWe aimed to evaluate the association between initial empirical antibiotic therapy (IEAT) and necrotizing enterocolitis (NEC) in very preterm infants at different early onset sepsis (EOS) risk.

methodsThis prospective, observational, multi-center study enrolled very low birth weight (VLBW) infants of < 32 weeks' gestation without culture-proven EOS. Infants delivered by cesarean section, without rupture of membranes before delivery, and without maternal chorioamnionitis were categorized as low-risk for EOS. Competing risk Cox regression analysis and cumulative incidence function curves were used to analyse the association between the duration of IEAT (0 days, < 3 days, 3-5 days or > 5 days) and NEC cumulative incidence, and death was considered as a competing risk. Finally, restricted cubic spline (RCS) models were used to further examine the relationship between time-varying antibiotic exposure and the risk of NEC.

resultsOf the 11678 included infants, 2767 infants were categorized as low risk for EOS. In the whole cohort and the infants with non-low-risk EOS, IEAT < 3 days showed a significantly lower risk of NEC (adjusted sHR 0.36, 95% CI [0.19,0.68]; (adjusted sHR 0.40, 95% CI [0.21, 0.79]) and IEAT for 3-5 days showed a lower risk of NEC (adjusted sHR 0.69, 95% CI [0.52, 0.94]; adjusted sHR 0.72, 95% CI [0.5, 1.03]), compared with those with No-IEAT. In the infants with low-risk EOS, there was no significant association between the duration of IEAT and the incidence of NEC. The RCS analysis showed a positive linear relationship between the duration of IEAT and the risk of NEC in very preterm infants at different EOS risk.

conclusionsCompeting-risk analysis showed that NEC risk may be inversely associated with short-term IEAT in the whole cohort and the non-low-risk EOS group. Notably, the risk of NEC tended to be higher with prolonged IEAT duration in very preterm infants at different EOS risk. These associational findings are exploratory and warrant further investigation.

Indexed as

Anti-Bacterial AgentsEnterocolitis, NecrotizingInfant, Premature, DiseasesNeonatal SepsisSepsisFemaleGestational AgeHumansIncidenceInfant, NewbornInfant, PrematureInfant, Very Low Birth WeightMaleProspective StudiesRisk FactorsAnti-Bacterial AgentsEarly onset sepsisInitial empirical antibiotic therapyNecrotizing enterocolitisVery preterm infants

Identifiers

PMID41703485
PMCPMC13015168

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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.