Time of onset of necrotizing enterocolitis in newborn infants with known prenatal cocaine exposure.
Cocaine exposure can lead to diminished gut-blood supply and thereby contribute to the pathogenesis of necrotizing enterocolitis (NEC). Investigating the hypothesis that NEC occurs at a younger age in cocaine-exposed infants, we reviewed 1,284 neonatal intensive care admissions. Infants with NEC were divided into cocaine-exposed and cocaine-nonexposed groups, each subdivided into two birth-weight groups, using 1,500 g as the cutoff weight. Time of onset of NEC for each infant was determined and survival curves for the cocaine-exposed and nonexposed groups were calculated using their birth-weight subdivision. Hazard function curves were done. Neonatal risk factors in both groups were compared. Twelve percent (28/231) of cocaine-exposed infants developed NEC stage II or III versus 3% (34/1053) in the nonexposed group (P < 0.05). Eight percent of cocaine-exposed and 2% of nonexposed survivors had NEC by day 7 versus 20% and 5% by day 28 after birth (P < 0.05). Infants > 1,500 g were at risk for NEC until day 8 only, whereas infants < or = 1,500 g had both an early and continuing risk for NEC with a biphasic pattern of onset. The accentuated peak in early-onset NEC may be attributed to antenatal cocaine exposure, while late-onset NEC in the < or = 1,500 g group probably relates to a variety of pathogenetic factors.
Lopez
S L
SL
Department of Pediatrics, Martin Luther King, Jr/Drew Medical Center, Los Angeles, CA 90059, USA.
Taeusch
H W
HW
Findlay
R D
RD
Walther
F J
FJ
D017668:Age of Onset; D003042:Cocaine / Q000009:adverse effects*; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012189:Retrospective Studies; D012307:Risk Factors
D003042:Cocaine