title: Risk factors and prevention for surgical intestinal disorders in extremely low birth weight infants.
abstract: OBJECTIVE
  Surgical intestinal disorders (SID), such as necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI), are serious morbidities in extremely low birth weight (ELBW, birth weight <1000 g) infants. From 2010, we performed enteral antifungal prophylaxis (EAP) in ELBWI to prevent for SID. The aim of this study was to identify disease-specific risk factors and to evaluate the efficacy of prevention for SID in ELBW infants.
  
  
  METHODS
  A retrospective chart review of all consecutive patients between January 2006 and March 2015, which included 323 ELBW infants who were admitted to Shizuoka Children's Hospital, was conducted.
  
  
  RESULTS
  The number of infants with NEC, FIP, and MRI was 9, 12, and 13, respectively; 28 in 323 ELBW infants died. The control group defined the cases were not SID. In-hospital mortality was higher in infants with NEC relative to those in the control group. On logistic regression analysis, low gestational age and cardiac malformations were associated with increased risk of NEC. IUGR were associated with increased risk of MRI. EAP decreased risk of NEC and FIP. Low gestational weight and NEC were associated with increased risk of death.
  
  
  CONCLUSIONS
  Survival to hospital discharge after operation for NEC in ELBW infants remains poor. EAP decreased risk of NEC and FIP in ELBW infants.
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan. smashace1018@yahoo.co.jp.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamoto
authors.affiliation: Department of Neonatalogy, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakazawa
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Sekioka
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Nomura
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Ooyama
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Neonatalogy, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Nogami
authors.affiliation: Department of Neonatalogy, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Van
authors.affiliation: Department of Neonatalogy, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Chisako
authors.initials: C
authors.lastname: Furuta
authors.affiliation: Department of Neonatalogy, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Reiji
authors.initials: R
authors.lastname: Nakano
authors.affiliation: Department of Neonatalogy, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Urushihara
mesh_terms: D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D045823:Ileus / Q000517:prevention & control / Q000601:surgery; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000601:surgery*; D007416:Intestinal Perforation / Q000517:prevention & control / Q000601:surgery; D008297:Male; D008470:Meconium; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Enterally antifungal prophylaxis; Extremely low birth weight infants; Focal intestinal perforation; Meconium-related ileus; Necrotizing enterocolitis; Surgical intestinal disorders