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美国康涅狄格州三家三级新生儿重症监护病房 28 年的流行病学研究:NECⅡ-Ⅲ期发病的时间和季节变化。

Temporal and seasonal variations in incidence of stage II and III NEC-a 28-year epidemiologic study from tertiary NICUs in Connecticut, USA.

机构信息

Department of Molecular and Cell Biology, University of Connecticut, Biology Physics Building (BPB), Storrs, CT, USA.

Computer Science and Engineering Department, University of Connecticut, Information Technology Building (ITE), Storrs, CT, USA.

出版信息

J Perinatol. 2021 May;41(5):1100-1109. doi: 10.1038/s41372-021-00961-7. Epub 2021 Feb 15.

DOI:10.1038/s41372-021-00961-7
PMID:33589729
Abstract

OBJECTIVE

To investigate seasonality and temporal trends in the incidence of NEC.

STUDY DESIGN

A retrospective cohort study from two tertiary NICUs in northern and central Connecticut involving 16,761 infants admitted over a 28-year period. Various perinatal and neonatal risk factors were evaluated by univariate, multivariate, and spectral density analyses.

RESULTS

Incidence of NEC was unchanged over the 28 years of study. Gestational age, birth weight, and birth-months (birth in April/May) were independently associated with stage II or III NEC even after adjusting for confounding factors (p < 0.05). Yearly NEC incidence showed a multi-modal distribution with spectral density spikes approximately every 10 years.

CONCLUSION(S): Temporal and seasonal factors may play a role in NEC with a peak incidence in infants born in April/May and periodicity spikes approximately every 10 years. These trends suggest non-random and possibly environmental factors influencing NEC.

摘要

目的

研究新生儿坏死性小肠结肠炎(NEC)的发病季节性和时间趋势。

研究设计

这是一项回顾性队列研究,纳入了康涅狄格州北部和中部的两家三级新生儿重症监护病房(NICU)的 16761 名婴儿,研究时间跨度为 28 年。通过单变量、多变量和频谱密度分析评估了各种围产期和新生儿期的危险因素。

结果

在 28 年的研究期间,NEC 的发病率没有变化。即使在调整了混杂因素后,胎龄、出生体重和出生月份(4/5 月)仍与 II 或 III 期 NEC 独立相关(p<0.05)。每年的 NEC 发病率呈多峰分布,频谱密度峰值约每 10 年出现一次。

结论

时间和季节因素可能与 NEC 有关,4/5 月出生的婴儿发病率较高,每隔约 10 年出现周期性高峰。这些趋势表明,非随机的、可能与环境有关的因素影响着 NEC 的发生。

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Spontaneous intestinal perforation (SIP) will soon become the most common form of surgical bowel disease in the extremely low birth weight (ELBW) infant.自发性肠穿孔(SIP)很快将成为极低出生体重(ELBW)婴儿中最常见的外科肠道疾病形式。
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