title: Intestinal perforation in very-low-birth-weight infants with necrotizing enterocolitis.
abstract: OBJECTIVE
  To identify risk factors for intestinal perforation in very-low-birth-weight (VLBW) infants with necrotizing enterocolitis (NEC).
  
  
  METHODS
  Retrospective case-control study over a 10-year period, using univariate and multivariate logistic regression analyses to compare all VLBW infants treated for perforated NEC, with two age and weight-matched groups: infants with non-perforated NEC and infants without NEC.
  
  
  RESULTS
  Twenty infants with perforated NEC were matched to 20 infants with non-perforated NEC and 38 infants without NEC. Infants with perforated NEC were younger (p<0.01) and had higher rates of abdominal distention, metabolic acidosis, hyperglycemia and elevated liver enzymes (p<0.05). On logistic regression analysis, abdominal distention was associated with an increased risk of intestinal perforation (OR 39.8, 95% CI 2.71-585) and late onset of NEC (one-day increments) was associated with a decreased risk (OR 0.93, 95% CI 0.87-1.0).
  
  
  CONCLUSIONS
  Identification of abdominal distention at an early age in VLBW infants should lead to increased vigilance for signs of perforated NEC and may enable early intervention.
authors.affiliation: Neonatal Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
authors.forename: Nehama
authors.initials: N
authors.lastname: Linder
authors.forename: Naama
authors.initials: N
authors.lastname: Hammel
authors.forename: Adriana
authors.initials: A
authors.lastname: Hernandez
authors.forename: Elena
authors.initials: E
authors.lastname: Fridman
authors.forename: Elena
authors.initials: E
authors.lastname: Dlugy
authors.forename: Tina
authors.initials: T
authors.lastname: Herscovici
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
mesh_terms: D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000150:complications*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors