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J Perinatol. 2011 Aug;31(8):519-23. doi: 10.1038/jp.2010.193. Epub 2011 Jan 27.

The age of necrotizing enterocolitis onset: an application of Sartwell's incubation period model.

Author information

  • 1Division of Gastroenterology, St Louis Children's Hospital, Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA.

Abstract

OBJECTIVE:

Model age of necrotizing enterocolitis (NEC) onset applying Sartwell's model of incubation periods, and examine its relationship to gestational age (GA).

STUDY DESIGN:

Retrospective chart review of St Louis Children's Hospital neonates diagnosed with NEC (≥Bell's stage II) from 2004 to 2008, inclusive.

RESULT:

The relationship between age of NEC (N=84 cases) onset and GA best fits a non-linear model, with infants ≤28 weeks having a disproportionately longer time to onset than older GA groups and explained 50.3% of the variability in age of NEC onset. Additional clinical variables provided no improvement in explaining age of NEC onset. Application of Sartwell's model to age of NEC onset proved a good fit, when birth is used as the common exposure episode, and age is equivalent of the incubation period.

CONCLUSION:

The relationship between day of NEC diagnosis and GA is non-linear, with lower GA infants having disproportionately longer time to onset. Despite these GA differences, the fit to Sartwell's model for incubation periods model is consistent with NEC being a consequence of an event that occurs at or soon after birth.

PMID:
21273988
[PubMed - indexed for MEDLINE]
PMCID:
PMC3145821
Free PMC Article

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