Department of Neonatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Faculty of Medical Sciences, Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open. 2023 Jul 24;13(7):e070638. doi: 10.1136/bmjopen-2022-070638.
Review of age of onset of necrotising enterocolitis (NEC) and focal intestinal perforation (FIP) in very preterm (≤32 weeks) and/or very low birthweight (VLBW, ≤1500 g) infants.
Preregistered review undertaken according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses in July 2021 and updated October 2021.
MEDLINE/ PubMed, Embase, CINAHL and Cochrane Central Register of Controlled Trials.
Eligible studies reported age of onset of NEC and/or FIP in randomised controlled trials of >200 or observational studies of >500 infants.
Titles/abstracts were screened; eligible articles underwent data extraction. Age of onset as day of life (DOL) and/or corrected gestational age (CGA) were extracted alongside study information, such as NEC definition, included population, intervention, location and dates studied. Weighted means were used to compare onset by birth gestation, study type, NEC definition, trial intervention, location and dates studied. Comparison was done by Mann-Whitney U test or one-way analysis of variance.
Of the 747 screened studies 188 were eligible. Removal of duplicates, studies without onset data and ineligible populations left 10 RCTs and 14 observational studies contributing 51 NEC cohorts; 49 reported onset DOL and 14 CGA. 2984 cases of NEC had average DOL onset of 16.7 (15.5 in RCTs, 16.9 in observational studies), and CGA onset of 30.1 weeks. Gestation did not impact DOL onset. No other demographic feature impacted NEC onset. Few studies included data on FIP.
Average onset of NEC in exclusively very preterm/very low birthweight infants is in the third week of life and unlike in cohorts including more mature or heavier infants is not impacted by birth gestation.
回顾极早产儿（≤32 周）和/或极低出生体重儿（VLBW，≤1500g）坏死性小肠结肠炎（NEC）和局灶性肠穿孔（FIP）的发病年龄。
根据 2021 年 7 月的系统评价和荟萃分析首选报告项目进行预先注册的综述，并于 2021 年 10 月进行更新。
MEDLINE/PubMed、Embase、CINAHL 和 Cochrane 对照试验中心注册库。
纳入的研究报告了随机对照试验中>200 例或观察性研究中>500 例婴儿的 NEC 和/或 FIP 发病年龄。
筛选标题/摘要；对符合条件的文章进行数据提取。发病年龄以出生后天数（DOL）和/或校正胎龄（CGA）表示，并提取研究信息，如 NEC 定义、纳入人群、干预措施、研究地点和研究日期。使用加权平均值比较出生时胎龄、研究类型、NEC 定义、试验干预、研究地点和研究日期的发病年龄。比较采用 Mann-Whitney U 检验或单向方差分析。
在 747 项筛选研究中，有 188 项符合条件。去除重复项、无发病数据的研究和不适合的人群后，有 10 项 RCT 和 14 项观察性研究纳入了 51 个 NEC 队列；其中 49 项报告了发病 DOL，14 项报告了 CGA 发病。2984 例 NEC 的平均 DOL 发病时间为 16.7（RCT 为 15.5，观察性研究为 16.9），CGA 发病时间为 30.1 周。胎龄对 DOL 发病时间没有影响。其他人口统计学特征均不影响 NEC 的发病时间。少数研究包含了 FIP 的数据。
在仅为极早产儿/极低出生体重儿中，NEC 的平均发病时间为生命的第三周，与包括更成熟或更重的婴儿的队列不同，发病时间不受出生胎龄的影响。
