title: Superior mesenteric artery Doppler is poor at predicting feed intolerance and NEC in preterm small for gestational age neonates.
abstract: OBJECTIVE
  To study SMA Doppler for predicting feed intolerance and necrotizing enterocolitis (NEC) in preterm SGA neonates with umbilical artery absent/reversed end diastolic flow (A/REDF).
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  SGA neonates <36 weeks born with antenatally diagnosed A/REDF formed cases. Those with normal Doppler formed controls. Primary outcomes were feed intolerance and NEC. Peak systolic velocity, end diastolic velocity (EDV), time-averaged mean velocity, pulsatility index and resistive index (RI) were measured in SMA Doppler done postnatally on days 1 and 5.
  
  
  RESULTS
  Fifty neonates were enrolled in each group. Gestation, birth weight, gender and Apgar scores were comparable. Feed intolerance rate was similar (A/REDF: 26% versus controls: 20%, p 0.48), NEC was commoner in A/REDF group (32% versus 4%, p < 0.001). Baseline SMA Doppler indices were similar; RI on day 1 was higher in babies with A/REDF [5.4 (IQR 3.3, 7.3)] who developed NEC compared to controls [3.3 (IQR 1.7, 3.9)], (p 0.049). RI of 3.63 on day 1 had only a sensitivity of 61% and a specificity of 57% in predicting NEC in A/REDF group (area under curve (AUC) 0.61, 95% CI: 0.43-0.79, p = 0.25). Similarly, EDV of 8.7 cm/s had only a sensitivity of 61% and a specificity of 60% for the prediction of NEC (AUC of 0.64, 95% CI: 0.47-0.81, p = 0.16).
  
  
  CONCLUSIONS
  Postnatal SMA Doppler indices do not predict feed intolerance and NEC in preterm SGA babies with A/REDF.
authors.affiliation: Neonatal Unit, Department of Pediatrics .
authors.forename: Deepak
authors.initials: D
authors.lastname: Louis
authors.forename: Kanya
authors.initials: K
authors.lastname: Mukhopadhyay
authors.forename: Kushaljit Singh
authors.initials: KS
authors.lastname: Sodhi
authors.forename: Vanita
authors.initials: V
authors.lastname: Jain
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
mesh_terms: D001783:Blood Flow Velocity; D004435:Eating; D020345:Enterocolitis, Necrotizing / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007228:Infant Nutrition Disorders / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007236:Infant, Small for Gestational Age / Q000502:physiology; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011379:Prognosis; D018608:Ultrasonography, Doppler