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新生儿坏死性小肠结肠炎的母亲风险因素。

Maternal risk factors for neonatal necrotizing enterocolitis.

作者信息

March Melissa I, Gupta Munish, Modest Anna M, Wu Lily, Hacker Michele R, Martin Camilia R, Rana Sarosh

机构信息

a Department of Obstetrics and Gynecology and.

b Division of Maternal-Fetal Medicine , Beth Israel Deaconess Medical Center , Boston , MA , USA.

出版信息

J Matern Fetal Neonatal Med. 2015 Jul;28(11):1285-1290. doi: 10.3109/14767058.2014.951624. Epub 2014 Aug 27.

Abstract

OBJECTIVE

This study aimed to investigate the relationship between maternal hypertensive disease and other risk factors and the neonatal development of necrotizing enterocolitis (NEC).

METHODS

This was a retrospective case-control study of infants with NEC from 2008 to 2012. The primary exposure of interest was maternal hypertensive disease, which has been hypothesized to put infants at risk for NEC. Other variables collected included demographics, pregnancy complications, medications and neonatal hospital course. Data were abstracted from medical records.

RESULTS

Twenty-eight cases of singleton neonates with NEC and 81 matched controls were identified and analyzed. There was no significant difference in the primary outcome. Fetuses with an antenatal diagnosis of growth restriction were more likely to develop NEC (p = 0.008). Infants with NEC had lower median birth weight than infants without NEC (p = 0.009). Infants with NEC had more late-onset sepsis (p = 0.01) and mortality before discharge (p = 0.001).

CONCLUSIONS

The factors identified by this case-control study that increased the risk of neonatal NEC included intrauterine growth restriction and lower neonatal birth weight. The primary exposure, hypertensive disease, did not show a significantly increased risk of neonatal NEC; however, there was a nearly two-fold difference observed. Our study was underpowered to detect the observed difference.

摘要

目的

本研究旨在调查孕产妇高血压疾病及其他危险因素与新生儿坏死性小肠结肠炎(NEC)发生发展之间的关系。

方法

这是一项针对2008年至2012年患NEC婴儿的回顾性病例对照研究。主要关注的暴露因素是孕产妇高血压疾病,据推测该疾病会使婴儿面临患NEC的风险。收集的其他变量包括人口统计学资料、妊娠并发症、用药情况及新生儿住院病程。数据从病历中提取。

结果

确定并分析了28例患NEC的单胎新生儿病例及81例匹配对照。主要结局无显著差异。产前诊断为生长受限的胎儿更易发生NEC(p = 0.008)。患NEC的婴儿出生体重中位数低于未患NEC的婴儿(p = 0.009)。患NEC的婴儿发生晚发性败血症的比例更高(p = 0.01),出院前死亡率也更高(p = 0.001)。

结论

该病例对照研究确定的增加新生儿NEC风险的因素包括宫内生长受限和较低的新生儿出生体重。主要暴露因素高血压疾病并未显示出新生儿NEC风险显著增加;然而,观察到的差异接近两倍。我们的研究检测该差异的效能不足。

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