Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants
Despite the clinical relevance of necrotizing enterocolitis (NEC), it remains difficult to predict which preterm infants are more likely to develop NEC. Contrary to the neonatal risk factors for the development of NEC, little information is available regarding maternal (prenatal) risk factors. We ai...
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Elsevier
2017-02-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957216300614 |
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| author | Ju-young Lee Kyo-Hoon Park Ahra Kim Hye-Ran Yang Eun-Young Jung Soo-Hyun Cho |
| author_facet | Ju-young Lee Kyo-Hoon Park Ahra Kim Hye-Ran Yang Eun-Young Jung Soo-Hyun Cho |
| author_sort | Ju-young Lee |
| collection | DOAJ |
| description | Despite the clinical relevance of necrotizing enterocolitis (NEC), it remains difficult to predict which preterm infants are more likely to develop NEC. Contrary to the neonatal risk factors for the development of NEC, little information is available regarding maternal (prenatal) risk factors. We aimed to identify maternal risk factors associated with the subsequent development of NEC in very preterm infants and to determine whether the placental inflammatory lesions were related to the NEC.
Methods: This retrospective cohort study examined newborns born at < 32 weeks (n=354) between July 2003 and July 2014 at a university teaching hospital. Medical records of eligible newborns and their mothers were reviewed. Maternal blood white blood cell and differential counts were measured at admission and the placentas were examined histologically after delivery. The primary outcome measure was NEC Bell Stage≥IIa. Bivariate analyses and multivariate logistic regression were used for the statistical analyses.
Results: NEC was diagnosed in 26 of 354 very preterm infants (7.3%), including 19 Stage II and seven Stage III infants. Multivariate regression analysis identified maternal neutrophil-to-lymphocyte ratio [odds ratio (OR)=1.08, p=0.002], multiparity (OR=3.41, p=0.013), and birth weight (OR=0.07 per kg increase, p=0.01), but not clinical and histological chorioamnionitis and funisitis as significant predictors of NEC.
Conclusion: Maternal neutrophil-to-lymphocyte ratio, parity, and birth weight can independently predict the risk of NEC in very preterm infants, whereas clinical and histological chorioamnionitis and funisitis are not predictive of NEC. |
| format | Article |
| id | doaj-art-63eca6de0e3a4e04bea83610aa57c7b3 |
| institution | Kabale University |
| issn | 1875-9572 |
| language | English |
| publishDate | 2017-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-63eca6de0e3a4e04bea83610aa57c7b32025-08-20T03:49:17ZengElsevierPediatrics and Neonatology1875-95722017-02-01581576210.1016/j.pedneo.2016.01.005Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm InfantsJu-young Lee0Kyo-Hoon Park1Ahra Kim2Hye-Ran Yang3Eun-Young Jung4Soo-Hyun Cho5Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Pediatrics, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDespite the clinical relevance of necrotizing enterocolitis (NEC), it remains difficult to predict which preterm infants are more likely to develop NEC. Contrary to the neonatal risk factors for the development of NEC, little information is available regarding maternal (prenatal) risk factors. We aimed to identify maternal risk factors associated with the subsequent development of NEC in very preterm infants and to determine whether the placental inflammatory lesions were related to the NEC. Methods: This retrospective cohort study examined newborns born at < 32 weeks (n=354) between July 2003 and July 2014 at a university teaching hospital. Medical records of eligible newborns and their mothers were reviewed. Maternal blood white blood cell and differential counts were measured at admission and the placentas were examined histologically after delivery. The primary outcome measure was NEC Bell Stage≥IIa. Bivariate analyses and multivariate logistic regression were used for the statistical analyses. Results: NEC was diagnosed in 26 of 354 very preterm infants (7.3%), including 19 Stage II and seven Stage III infants. Multivariate regression analysis identified maternal neutrophil-to-lymphocyte ratio [odds ratio (OR)=1.08, p=0.002], multiparity (OR=3.41, p=0.013), and birth weight (OR=0.07 per kg increase, p=0.01), but not clinical and histological chorioamnionitis and funisitis as significant predictors of NEC. Conclusion: Maternal neutrophil-to-lymphocyte ratio, parity, and birth weight can independently predict the risk of NEC in very preterm infants, whereas clinical and histological chorioamnionitis and funisitis are not predictive of NEC.http://www.sciencedirect.com/science/article/pii/S1875957216300614chorioamnionitisnecrotizing enterocolitisneutrophil-to-lymphocyte ratioplacentaspreterm |
| spellingShingle | Ju-young Lee Kyo-Hoon Park Ahra Kim Hye-Ran Yang Eun-Young Jung Soo-Hyun Cho Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants Pediatrics and Neonatology chorioamnionitis necrotizing enterocolitis neutrophil-to-lymphocyte ratio placentas preterm |
| title | Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants |
| title_full | Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants |
| title_fullStr | Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants |
| title_full_unstemmed | Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants |
| title_short | Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants |
| title_sort | maternal and placental risk factors for developing necrotizing enterocolitis in very preterm infants |
| topic | chorioamnionitis necrotizing enterocolitis neutrophil-to-lymphocyte ratio placentas preterm |
| url | http://www.sciencedirect.com/science/article/pii/S1875957216300614 |
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