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Eur J Pediatr Surg. 2015 Dec;25(6):520-5. doi: 10.1055/s-0034-1396418. Epub 2015 Feb 2.

Spontaneous Intestinal Perforation and Necrotizing Enterocolitis: A 16-Year Retrospective Study from a Single Center.

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Department of Chirurgie Pédiatrique, CHU Nantes, Nantes, France.
Institut des Maladies de l'Appareil Digestif DHU 2020, INSERM U913, Nantes, France.
Department of Neonatology, CHU Nantes, Nantes, France.



Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are serious abdominal conditions that affect preterm infants but are poorly understood. This single-center retrospective study was performed to identify the factors associated with NEC and SIP.


This study involved 3,464 preterm infants recruited over 16 years. A total of 136 NEC and 24 SIP were analyzed and adjusted odds ratios (aOR) were determined by logistic regression.


Compared with the controls, NEC was associated with a Z-score for birth weight lower than -1 (aOR = 2.1 [1.1-3.9], p = 0.02) and lower than -2 (aOR = 4.4 [1.8-10.4], p < 0.01). NEC was associated with gestational ages of less than 31 weeks and with breech presentations (aOR = 1.5 [1.0-2.3], p = 0.03). In contrast, compared with the controls, SIP was associated with gestational ages of less than 26 weeks (aOR = 17.4 [3.1-96.2], p < 0.001) and multiple pregnancy (aOR = 2.9 [1.2-6.9], p = 0.02). Rates of mortality and cerebral lesions were higher in patients with NEC (25.0 and 13.2%, respectively) than with the controls (10.1 and 6.9%, respectively) and similar between patients with SIP (12.5 and 8.3%, respectively) and the controls. CONCLUSIon: NEC and SIP differed in risk factors and prognosis. Early distinction of SIP from NEC could impact on surgical decision.

[Indexed for MEDLINE]

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