Abuelazm Somaya, Iben Sabine, Farghaly Mohsen, Mohamed Mohamed A, Aly Hany
Neonatology Division, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
Faculty of Medicine, Aswan University, Aswan, Egypt.
Pediatr Res. 2025 Feb;97(3):1025-1030. doi: 10.1038/s41390-024-03510-y. Epub 2024 Aug 24.
The pathogenesis of necrotizing enterocolitis (NEC) is multifactorial, placental abruption is associated with serious neonatal complications attributed to disruption of the maternal-fetal vascular interface. This study aimed to investigate the association between placental abruption and NEC.
We analyzed the United States (US) National Inpatient Sample (NIS) dataset for the years 2016-2018. Using the logistic regression model, the adjusted odds ratios (aOR) were calculated to assess the risk of NEC in infants born to mothers with placental abruption after controlling for significant confounders. Analyses were repeated after stratifying the population into two birth weight (BW) categories: <1500 g and ≥1500 g.
The study included 11,597,756 newborns. Placental abruption occurred in 0.16% of the population. NEC was diagnosed in 0.18% of infants, with a higher incidence (2.5%) in those born to mothers with placental abruption (aOR = 1.2, 95% CI: 1.1-1.3, p < 0.001). Placental abruption was associated with NEC only in infants with BW ≥ 1500 g (aOR = 1.34, 95% CI: 1.11-1.62, p 0.003).
Placental abruption is associated with an increased risk of NEC in neonates with BW ≥ 1500 g. Research is needed to explore the mechanisms behind this association and to develop targeted interventions to mitigate NEC risks in this population.
Placental abruption is associated with an increased risk of developing necrotizing enterocolitis (NEC) in neonates with a birth weight ≥1500 grams. This effect could be via direct in utero bowel injury or due to indirect postnatal compromise that occurs in these infants. This is the first study to specifically address the association between placental abruption and NEC in neonates ≥1500 g. The study used a national dataset that included all neonates delivered in the US, thereby allowing for the generalization of the findings after adjustment for multiple confounding factors. This study lays the groundwork for subsequent studies aimed at modifying feeding strategies and other neonatal management for the prevention of NEC in infants delivered after placental abruption.
坏死性小肠结肠炎（NEC）的发病机制是多因素的，胎盘早剥与严重的新生儿并发症相关，这归因于母胎血管界面的破坏。本研究旨在调查胎盘早剥与NEC之间的关联。
我们分析了2016 - 2018年美国国家住院样本（NIS）数据集。使用逻辑回归模型，计算调整后的比值比（aOR），以评估在控制了显著混杂因素后，胎盘早剥母亲所生婴儿患NEC的风险。在将人群分为两个出生体重（BW）类别：<1500 g和≥1500 g后重复进行分析。
该研究纳入了11,597,756名新生儿。胎盘早剥发生在0.16%的人群中。0.18%的婴儿被诊断为NEC，胎盘早剥母亲所生婴儿的发病率更高（2.5%）（aOR = 1.2，95% CI：1.1 - 1.3，p < 0.001）。胎盘早剥仅在BW≥1500 g的婴儿中与NEC相关（aOR = 1.34，95% CI：1.11 - 1.62，p = 0.003）。
胎盘早剥与BW≥1500 g的新生儿患NEC的风险增加相关。需要开展研究以探索这种关联背后的机制，并制定有针对性的干预措施，以降低该人群中NEC的风险。
胎盘早剥与出生体重≥1500克的新生儿发生坏死性小肠结肠炎（NEC）的风险增加相关。这种影响可能是通过子宫内直接的肠道损伤，或者是由于这些婴儿出生后发生的间接损害。这是第一项专门研究胎盘早剥与≥1500 g新生儿NEC之间关联的研究。该研究使用了包含美国所有分娩新生儿的全国性数据集，从而在调整多个混杂因素后使研究结果具有普遍性。本研究为后续旨在调整喂养策略和其他新生儿管理措施以预防胎盘早剥后分娩婴儿患NEC的研究奠定了基础。
