Fecal High-Mobility Group Box 1 as a Marker of Early Stage of Necrotizing Enterocolitis in Preterm Neonates (original) (raw)
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2015
Necrotizing enterocolitis (NEC) is an inflammatory disease of the intestine primarily affecting preterm infants. Currently, the diagnosis of NEC is based on a constellation of non-specific clinical symptoms and signs, radiologic findings, and laboratory data (Bell's staging criteria). However, a definitive diagnosis of NEC is difficult because of its similarity in presentation to other clinical conditions. Biomarkers measured in stool samples will better reflect inflammation and pathology specific to the intestine. Certain stool markers are able to identify inflammatory bowel disease in pediatric and …
Frontiers in Pediatrics, 2021
Background: Necrotizing enterocolitis (NEC) is a fatal disease where current diagnostic tools are insufficient for preventing NEC. Early predictive biomarkers could be beneficial in identifying infants at high risk of developing NEC.Objective: To explore early biomarkers for predicting NEC in extremely preterm infants (EPIs).Methods: Blood samples were collected on day 2 (median 1.7; range 1.5–2.0) from 40 EPI (median 25 gestational weeks; range 22–27): 11 developed NEC and 29 did not (controls). In each infant, 189 inflammatory, oncological, and vascular proteomic biomarkers were quantified through Proximity Extension Assay. Biomarker expression and clinical data were compared between the NEC group and Controls. Based on biomarker differences, controls were sorted automatically into three subgroups (1, 2, and 3) by a two-dimensional hierarchical clustering analysis.Results: None of the biomarkers differed in expression between all controls and the NEC group. Two biomarkers were hig...
Biomarkers for Infants at Risk for Necrotizing Enterocolitis: Clues to Prevention?
Pediatric Research, 2009
Necrotizing enterocolitis (NEC) is the most common severe gastrointestinal emergency that affects premature newborns. This disease often has a rapid onset with few, if any, antecedent signs that can be used to reliably predict its occurrence. Its rapid onset and progression to death, as well as its severe morbidity when the infant survives, begs for early diagnostic tools that may be used in determining those infants who would be at greatest risk for development of the disease and for whom early preventative measures could be targeted. Although studies have suggested efficacy of several techniques such as breath hydrogen, inflammatory mediators in blood, urine or stool, and genetic markers, these all have drawbacks limiting their use. The application of newly developed "omic" approaches may provide biomarkers for early diagnosis and targeted prevention of this disease.
Paediatrica Indonesiana
Background Necrotizing enterocolitis (NEC) is a prematurity-related complication of the gastrointestinal tract that affects 3-15% of preterm infants. Due to its atypical signs and symptoms, NEC is often diagnosed late, leading to mortality and morbidity. Objective To describe the incidence, characteristics, and survival rate of preterm infants with NEC in the Neonatal Unit of Cipto Mangunkusumo Hospital. Methods This prospective cohort study was conducted on preterm infants born in Cipto Mangunkusumo Hospital in 2019 who had NEC Bell stage 2 or higher. Subjects were recruited consecutively. NEC was classified into either early-onset (<14 days of life) or late-onset (?14 days of life). We identified the risk factors of mortality and survival using multiple Cox regression. Results Within the study period, 55/639 preterm infants born in Cipto Mangunkusumo Hospital were diagnosed with NEC. Mean gestational age was 31.16 (SD 2.63) weeks and mean birth weight was 1,378.12 (SD 438.26) g...
Risk Factors for Necrotizing Enterocolitis in Preterm Infants
Advances in Neonatal Care, 2008
Purpose-To examine 5 infant characteristics and health factors that might be risk factors for necrotizing enterocolitis (NEC) in preterm infants. Subjects-134 preterm infants at high risk for NEC due to either having a birthweight of <1500 grams or requiring mechanical ventilation at birth. Design-Descriptive secondary analysis using data from a larger longitudinal study. Methods-Weekly review of infant's medical record until discharge. Demographic questionnaire completed by mothers at time of enrollment. Data analysis done with logistic regression, Fischer's exact tests and correlations. Outcome Measures-Total number of days infant required mechanical ventilation, birthweight in grams, number of infections prior to NEC diagnosis, maternal race (Black, White or Asian), and infant gender were used to predict the development of NEC.
Scientific Reports, 2022
Necrotizing enterocolitis (NEC) is responsible for most morbidity and mortality in neonates. Early recognition of the clinical deterioration in newborns with NEC is essential to enhance the referral and management and potentially improve the outcomes. Here, we aimed to identify the prognostic factors and associate them with the clinical deterioration of preterm neonates with NEC. We analyzed the medical records of neonates with NEC admitted to our hospital from 2016 to 2021. We ascertained 214 neonates with NEC. The area under the receiver operating characteristic (ROC) curve and cutoff level of age at onset, C-reactive protein (CRP), leukocyte count, and platelet count for the clinical deterioration of preterm neonates with NEC was 0.644 and 10.5 days old, 0.694 and 4.5 mg/L, 0.513 and 12,200/mm 3 , and 0.418 and 79,500/mm 3 , respectively. Late-onset, history of blood transfusion, thrombocytopenia, and elevated CRP were significantly associated with the clinical deterioration of neonates with NEC (p = < 0.001, 0.017, 0.001, and < 0.001, respectively), while leukocytosis, gestational age, and birth weight were not (p = 0.073, 0.274, and 0.637, respectively). Multivariate analysis revealed that late-onset and elevated CRP were strongly associated with the clinical deterioration of neonates with NEC, with an odds ratio of 3.25 (95% CI = 1.49-7.09; p = 0.003) and 3.53 (95% CI = 1.57-7.95; p = 0.002), respectively. We reveal that late-onset and elevated CRP are the independent prognostic factor for the clinical deterioration of preterm neonates with NEC. Our findings suggest that we should closely monitor preterm neonates with NEC, particularly those with late-onset of the disease and those with an elevated CRP, to prevent further clinical deterioration and intervene earlier if necessary. Abbreviations PRC Packed red cell CRP C-reactive protein CI Confidence interval OR Odds ratio NEC Necrotizing enterocolitis Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency that affects preterm neonates 1,2. NEC is responsible for most perioperative fatalities in pediatric surgery, with a mortality rate of up to 19% 3. However, studies from developing countries on the clinical deterioration in preterm neonates are minimal. In addition, validated early indicators of clinical deterioration in preterm neonates with NEC are essential. Early predictors for surgery in premature neonates with NEC would help enhance referral and treatment pathways and potentially improve outcomes 4. Here, we aimed to identify the prognostic factors and associate them with the clinical deterioration of preterm neonates with NEC.
Necrotizing Enterocolitis in Preterm Neonates: Prognostic Factors and Outcome
Pakistan Journal of Health Sciences
Necrotizing Enterocolitis (NEC) contributes significantly to a high neonatal death rate in Pakistan and other developing countries. A number of elements related to its development are modifiable and can be addressed. Objectives: To evaluate the frequency of NEC, its associated factors and outcome in preterm babies. Methods: This retrospective, cross-sectional study was conducted at Ziauddin University Hospital, Karachi. Medical records of admitted preterm newborns from 1st December 2020 till 1st December 2022 were reviewed and neonates meeting the modified Bell’s diagnostic criteria ,with NEC stage II and III were included. Data pertaining to antenatal period, delivery and postnatal course of the disease were recorded . Data analysis were done using SPSS version-20 and results expressed as frequencies and percentages. Chi square test was applied with p-value statistical significance set at <0.05. Results: The prevalence of NEC was observed to be 7.1%. Male to female ratio was 1.6...
Frequency of Necrotizing Enterocolitis in Preterm Neonates and Their Outcome During Hospital Stay
2017
Background: Neonatal necrotizing enterocolitis [NEC], characterized by intestinal necrosis and pneumatosis intestinal, is the most common gastrointestinal emergency in the premature newborns [1]. The disease has an incidence rate of 2 to 5% in premature infants. The incidence rate increases to 13% in those weighing 1,500 gram at birth. NEC has a mortality rate of 10 to 55%. Objective: To determine the frequency of necrotizing enterocolitis in preterm neonates along with their outcome during stay in hospital. Methods: All premature newborn with morbidity admitted at Neonatal Intensive Care Unit [NICU] the Children Hospital, PIMS, Islamabad were screened for enrolment. A total of 156 premature newborn who fulfilled the inclusion criteria were enrolled in the current study. The duration of study was 6 months. At the time of enrolment, demographic characteristics of all the enrolled babies were obtained and noted on the proforma specially designed for the study. Delivery complications, ...
Frequency and Outcome of Necrotizing Enterocolitis in Preterm Neonates
Journal of Ayub Medical College, Abbottabad : JAMC
Necrotizing enterocolitis (NEC) is the commonest gastrointestinal emergency in neonates. It is associated with high mortality and morbidity. Present study was conducted to determine the frequency of necrotizing enterocolitis in preterm neonates along with their outcome during stay in hospital. This was descriptive case series carried out in Neonatal Intensive Care Unit (NICU) of Paediatrics department, POF Hospital Wah Cantt from August 2010 to February 2011. All the preterm neonates admitted in NICU POF Hospital were included in the study. Patients were clerked on a pre-designed pro forma. A total of 196 neonates were enrolled and 28 (14%) were diagnosed with NEC. Outcome analysis of these 28 patients with NEC revealed that 16 patients (57.14%) were discharged while 11 (39.28%) expired and one (3.5%) was referred. There is a high incidence in preterm-low birth weight babies presenting in our set-up, with high mortality rates.
2013
Background: Necrotizing enterocolitis (NEC) is a devastating intestinal disease that afflicts 10% of extremely preterm infants. The contribution of early intestinal colonization to NEC onset is not understood, and predictive biomarkers to guide prevention are lacking. We analyzed banked stool and urine samples collected prior to disease onset from infants <29 weeks gestational age, including 11 infants who developed NEC and 21 matched controls who survived free of NEC. Stool bacterial communities were profiled by 16S rRNA gene sequencing. Urinary metabolomic profiles were assessed by NMR.