title: Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes.
abstract: We aim to determine risk factors and clinical outcomes for bowel perforation in premature infants with NEC. We analyzed clinical data of 57 cases of premature infants with NEC at our NICU between January 2010 and December 2012. Based on the presence of bowel perforation, we divided these infants into two groups: perforated NEC group (n = 10) and nonperforated NEC group (n = 47). We compared general information, clinical characteristics, and laboratory findings between groups. The perforated NEC group, compared to the nonperforated NEC group, had significantly lesser gestational age, lower birth weight, higher prevalence of apnea, mechanical ventilation, sepsis and shock, lower blood pH, higher levels of blood glucose, abnormal WBC count and thrombocytopenia, and elevated CRP (all P < 0.05). Moreover, the perforated NEC group had significantly longer durations of fasting and TPN usage, higher incidences of EUGR and cholestasis, longer duration of antibiotics, higher frequency of advanced antibiotics use, and poorer prognosis than the nonperforated NEC group (all P < 0.05). Bowel perforation in premature infants with NEC was associated with multiple risk factors. Early identification of some of these risk factors in premature infants with NEC may help implement early intervention to reduce the incidence of bowel perforation and thereby improve the prognosis.
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Infectious Disease, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Jianmei
authors.initials: J
authors.lastname: Tian
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Xingli
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Cheng
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Xueping
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215003, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Xiao