Urine NMR Metabolomics Profile of Preterm Infants With Necrotizing Enterocolitis Over the First Two Months of Life: A Pilot Longitudinal Case-Control Study

Objective: To investigate changes in the urine metabolome of very low birth weight preterm newborns with necrotizing enterocolitis (NEC) and feed intolerance, we conducted a longitudinal study over the first 2 months of life. The metabolome of NEC newborns was compared with two control groups that did not develop NEC: the first one included preterm babies with feed intolerance, while the second one preterm babies with good feed tolerance.Methods: Newborns developing NEC within the 3 weeks of life were identified as early onset NEC, while the remaining as late onset NEC. Case-control matching was done according to the gestational age (±1 week), birth weight (± 200 g), and postnatal age. A total of 96 urine samples were collected and analyzed. In newborns with NEC, samples were collected before, during and after the diagnosis over the first 2 months of life, while in controls samples were collected as close as possible to the postnatal age of newborns with NEC. Proton nuclear magnetic resonance (1H NMR) spectroscopy was used for metabolomic analysis. Data were analyzed by univariate and multivariate statistical analysis.Results: In all the preterm newborns, urine levels of betaine, glycine, succinate, and citrate positively correlated with postnatal age. Suberate and lactate correlated with postnatal age in preterms with NEC and in controls with food intolerance, while N,N-dimethylglycine (N,N-DMG) correlated only in controls with good digestive tolerance. Preterm controls with feed intolerance showed a progressive significant decrease of N-methylnicotinamide and carnitine. Lactate, betaine, myo-inositol, urea, creatinine, and N,N-dimethylglycine discriminated late-onset NEC from controls with good feed tolerance.Conclusion: Our findings are discussed in terms of contributions from nutritional and clinical managements of patients and gut microbiota.

Download Full-text

Severe sepsis and retinopathy of prematurity in very low birth weight preterm newborns in a third-level healthcare center in Lima, Peru between 2008 and 2018: A case-control study

Medwave ◽

10.5867/medwave.2021.03.8157 ◽

2021 ◽

Vol 21 (03) ◽

pp. e8157-e8157

Author(s):

Alvaro Valdivia ◽

Daniela Bullard Elias ◽

Cecilia Herbozo ◽

German Málaga

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Odds Ratio ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Late Onset ◽

Case Control ◽

Late Onset Sepsis

Background Retinopathy of prematurity is the leading worldwide cause of visual impairment. There is little available data on its epidemiology and related factors and consequences in developing countries such as Peru. Due to this lack of information, we decided to do this study. Objectives To evaluate factors related to the development of retinopathy of prematurity in very low birth weight newborn patients. Methods We did a case-control (paired 1:1) study of patients admitted to the Neonatal Intensive Care Unit of the Hospital Cayetano Heredia between 2008 and 2018 who had a complete record in the Neocosur network database (N = 293). The case was defined as a preterm newborn patient with a birth weight lower than 1500 grams who developed any type or stage of retinopathy of prematurity; control was defined as a patient with similar characteristics without retinopathy. Univariate and bivariate analysis (using logistic regression model) was performed to obtain the odds ratio with a 95% confidence interval. Results Data were obtained from 57 cases and 57 controls admitted to the Neonatal Intensive Care Unit at Hospital Cayetano Heredia. Late-onset sepsis was the main factor associated with retinopathy of prematurity (odds ratio 4.39; 95% confidence interval 1.23 to 15.76, p = 0.02). Additionally, we performed a bivariate and multivariate analysis that showed that exposure to supplementary oxygen at 36 weeks of postmenstrual age and retinopathy of prematurity were not significantly associated (8.47; 0.51 to 141.17, p = 0.14). Conclusions Patients with late-onset sepsis have a 4.39 times higher odds of developing retinopathy of prematurity. Prospective studies are needed with larger sample sizes.

Download Full-text

Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

Clinical and Experimental Pediatrics ◽

10.3345/cep.2019.00381 ◽

2020 ◽

Vol 63 (6) ◽

pp. 226-231 ◽

Cited By ~ 1

Author(s):

Ozge Serce Pehlevan ◽

Derya Benzer ◽

Tugba Gursoy ◽

Guner Karatekin ◽

Fahri Ovali

Keyword(s):

Randomized Controlled Trial ◽

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Gestational Age ◽

Very Low Birth Weight ◽

Late Onset ◽

Controlled Trial ◽

Randomized Controlled ◽

Significant Difference

Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

Download Full-text

Morbidity Associated with Patent Ductus Arteriosus in Preterm Newborns: A Retrospective Case-Control Study

10.21203/rs.3.rs-54756/v1 ◽

2020 ◽

Author(s):

Gianluca Terrin ◽

Maria Di Chiara ◽

Giovanni Boscarino ◽

Valentina Metrangolo ◽

Francesca Faccioli ◽

...

Keyword(s):

Birth Weight ◽

Patent Ductus Arteriosus ◽

Case Control Study ◽

Very Low Birth Weight ◽

Ductus Arteriosus ◽

Case Control ◽

Extremely Preterm ◽

Preterm Newborns ◽

Control Study ◽

Patent Ductus

Abstract Introduction: Association between persistency of a patent ductus arteriosus (PDA) and morbidity in preterm newborns is still controversial. We aimed to investigate the relation between PDA and morbidity in a large retrospective study.Methods: A case-control study including neonates consecutively admitted to the Neonatal Intensive Care Unit (NICU), with gestational age (GA) ≤ 32 weeks or body birth weight (BW) ≤ 1500 g, over a 5-year period. Newborns were divided into Cases and Controls, according with the presence or absence of a hemodynamically significant PDA (hs-PDA).Results: We enrolled 85 Cases and 193 Controls. Subjects with hs-PDA had significantly (p<0.001) lower GA (26.7 w, 95%CI 27.1-28.0 vs. 30.1 w, 95%CI 29.7-30.4), BW (1024 g, 95% CI 952-1097 vs. 1310 g 95%CI 1263-1358) and an increased morbidity (60.0% vs. 18.7%). In a sub-group of extremely preterm newborns (GA < 29 weeks and BW < 1000 g), the rate of BPD was significantly increased in Cases (31.7%) compared with Controls (5.9%, p=0.033). Multivariate analysis showed that morbidity significantly depended on hs-PDA, GA and BW, and that, in extremely preterms, the hs-PDA represented an independent risk factor for BPD.Conclusions: The presence of hs-PDA seemed to increase the risk of morbidity in very low birth weight (VLBW) infants. In extremely preterm newborns, the risk of bronchopulmonary dysplasia (BPD) depended on the occurrence of hs-PDA.

Download Full-text