MMSc, Division of Pediatric Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky 40202, USA.
Pediatrics. 2012 Jul;130(1):78-82. doi: 10.1542/peds.2011-3808. Epub 2012 Jun 11.
The maternal variables that affect fetal development and correlate with necrotizing enterocolitis (NEC), the most common gastrointestinal emergency in premature infants, are not well defined. We hypothesized that maternal risk factors were the primary determinant of future development of NEC.
Patients with NEC were identified from an established NICU database and were control-matched with 2 neonates treated at the same institution. The medical records of each patient during the NICU admission as well as the prenatal and delivery record of the patient's mother were reviewed. Perinatal data, including maternal smoking, maternal hypertension, maternal BMI, maternal gestational diabetes, conduct of labor and type of delivery, Apgar scores, types of feedings, and placental pathology, were examined, with P < .05 deemed significant.
A total of 73 neonates diagnosed with NEC and 146 matched controls were identified. Medical records for each subject and their mothers were reviewed (438 records total). Maternal cigarette smoking was significantly associated with the future development of NEC (P = .02). Maternal gestational diabetes, maternal hypertension, formula feeding, and pathologic chorioamnionitis or uteroplacental insufficiency did not correlate with NEC.
These data identified maternal cigarette smoking as the only risk factor that is associated with the development of NEC in premature infants. Our data imply that smoking delivers toxins and nicotine to the uterine microenvironment that can affect microvascular development and may predispose the fetus to future NEC.
影响胎儿发育并与坏死性小肠结肠炎（NEC）相关的母体变量，是早产儿最常见的胃肠道急症，但尚未明确。我们假设母体危险因素是未来 NEC 发展的主要决定因素。
从已建立的 NICU 数据库中确定患有 NEC 的患者，并与在同一机构接受治疗的 2 名新生儿进行对照匹配。回顾每位患者在 NICU 住院期间以及患者母亲的产前和分娩记录的医疗记录。检查围产期数据，包括母亲吸烟、母亲高血压、母亲 BMI、母亲妊娠糖尿病、分娩过程和分娩类型、阿普加评分、喂养类型以及胎盘病理学，P <.05 被认为具有统计学意义。
共确定了 73 名患有 NEC 的新生儿和 146 名匹配的对照。对每个受试者及其母亲的医疗记录进行了回顾（共 438 份记录）。母亲吸烟与未来 NEC 的发展明显相关（P =.02）。母亲妊娠糖尿病、母亲高血压、配方奶喂养以及病理绒毛膜羊膜炎或胎盘功能不全与 NEC 不相关。
这些数据确定了母亲吸烟是与早产儿 NEC 发展相关的唯一危险因素。我们的数据表明，吸烟会向子宫微环境输送毒素和尼古丁，从而影响微血管的发育，并可能使胎儿易患未来的 NEC。
