title: The antecedents and correlates of necrotizing enterocolitis and spontaneous intestinal perforation among infants born before the 28th week of gestation.
abstract: OBJECTIVE
  To identify antecedents of "medical" necrotizing enterocolitis (mNEC), "surgical" NEC (sNEC), and spontaneous intestinal perforation (SIP) in newborns delivered before 28 weeks gestation.
  
  
  METHODS
  Prospective multicenter cohort study. During study period, 2002- 2004, women delivering before 28 weeks gestation at one of 14 participating institutions were enrolled. Well defined antenatal and postnatal variables were collected. Bivariate analyses were performed to identify candidates for developing multinomial multivariable time-oriented logistic regression models.
  
  
  RESULTS
  Of the 1320 infants, 5% had mNEC, 6% had sNEC, and 4% had SIP. Antecedents of mNEC included mother's identification as Black, consumption of aspirin during the pregnancy, and vaginal bleeding after the 12th week of gestation. For sNEC the antecedents were maternal self- support, obesity and anemia during the pregnancy, birth before the 24th week, birth weight ≤750gm, and receipt of fresh frozen plasma (FFP) during the first postnatal week. An infant was at increased risk of SIP if the placenta had increased syncytial knots, birth occurred before the 24th week, and received FFP during the first week.
  
  
  CONCLUSIONS
  Maternal and neonatal characteristics might help identify at-risk ELGANs for NEC and SIP, who then may potentially benefit from targeted preventive strategies.
authors.affiliation: Department of Pediatrics, Baystate Children's Hospital, Springfield, MA, USA.|Tufts University School of Medicine, Boston, MA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, Baystate Children's Hospital, Springfield, MA, USA.|Tufts University School of Medicine, Boston, MA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Shah
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: E N
authors.initials: EN
authors.lastname: Allred
authors.affiliation: Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors.forename: M
authors.initials: M
authors.lastname: Grzybowski
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Department of Pediatrics, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Martin
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Leviton
mesh_terms: D000328:Adult; D001241:Aspirin / Q000009:adverse effects; D001724:Birth Weight; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009035:Mothers; D010920:Placenta / Q000503:physiopathology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014592:Uterine Hemorrhage
chemical_list: D001241:Aspirin
keywords: Antenatal and perinatal correlates; necrotizing enterocolitis; spontaneous intestinal perforation