Neonatal Diagnosis and Treatment Center, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Chongqing, P.R. China.
Int J Immunopathol Pharmacol. 2020 Jan-Dec;34:2058738420963818. doi: 10.1177/2058738420963818.
Sepsis, a severe infectious disease in the neonatal period, is considered a risk factor for necrotizing enterocolitis (NEC). To investigate the specific risk factors for NEC in septic infants, septic infants admitted to our center from January 2010 to April 2018 were included. Septic neonates with proven NEC (Bell's stage ⩾II) were enrolled in the NEC group, and those without NEC were enrolled in the control group. Demographics, clinical characteristics, and risk factors were compared between the two groups. Univariate and logistic regression analyses were used to evaluate the potential risk factors for NEC. A total of 610 septic neonates were included, of whom 78 (12.8%) had complicated NEC. The univariate analysis indicated that infants with NEC had a lower birth weight, a lower gestational age, and older age on admission than those without NEC ( < 0.05). Higher rates of anemia, prolonged rupture of membranes (PROM) (⩾18 h), pregnancy-induced hypertension, late-onset sepsis (LOS), red blood cell transfusion and hypoalbuminemia were observed in the NEC group than in the non-NEC group (P<0.05). Logistic regression analysis revealed LOS ( = 0.000), red blood cell transfusion ( = 0.001) and hypoalbuminemia ( = 0.001) were associated with the development of NEC. Among NEC infants, those who needed red blood cell transfusion had a longer hospitalization duration than those who did not need transfusion ( < 0.05). LOS, red blood cell transfusion and hypoalbuminemia were independent risk factors for the development of NEC in infants with sepsis. Taking measures to reduce the occurrence of hypoproteinemia and severe anemia may help to reduce the occurrence of NEC in septic neonates.
新生儿败血症是一种严重的感染性疾病，被认为是坏死性小肠结肠炎（NEC）的危险因素。为了探讨败血症患儿发生 NEC 的具体危险因素，我们纳入了 2010 年 1 月至 2018 年 4 月期间在我院住院的败血症患儿。将确诊为 NEC（Bell 分期 ⩾Ⅱ期）的败血症新生儿纳入 NEC 组，未发生 NEC 的患儿纳入对照组。比较两组患儿的一般资料、临床特征及危险因素。采用单因素及 Logistic 回归分析评估 NEC 的潜在危险因素。共纳入 610 例败血症新生儿，其中 78 例（12.8%）并发 NEC。单因素分析显示，与无 NEC 组相比，NEC 组患儿的出生体质量更低、胎龄更小、入院时年龄更大（均 P<0.05）。NEC 组患儿贫血、胎膜早破时间延长（⩾18 h）、妊娠高血压、晚发型败血症（LOS）、红细胞输注及低白蛋白血症的发生率均高于无 NEC 组（P<0.05）。Logistic 回归分析显示，LOS（ = 0.000）、红细胞输注（ = 0.001）及低白蛋白血症（ = 0.001）与 NEC 的发生有关。在 NEC 患儿中，需要输血的患儿的住院时间长于无需输血的患儿（P<0.05）。LOS、红细胞输注和低白蛋白血症是败血症患儿发生 NEC 的独立危险因素。采取措施减少低蛋白血症和严重贫血的发生可能有助于降低败血症新生儿 NEC 的发生风险。
