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J Perinatol. 2015 Aug;35(8):595-600. doi: 10.1038/jp.2015.41. Epub 2015 Apr 30.

Intestinal perforation in very preterm neonates: risk factors and outcomes.

Author information

1
Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
2
Department of Pediatrics, Foothills Hospital, University of Calgary, Calgary, AB, Canada.
3
Department of Pediatrics, London Health Sciences Center, University of Western Ontario, London, ON, Canada.
4
Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa University, Ottawa, ON, Canada.
5
Department of Pediatrics, Winnipeg Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada.
6
1] Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada [2] Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.

Abstract

OBJECTIVE:

To compare neonatal outcomes of preterm infants (born at <32 weeks' gestation) with focal/spontaneous intestinal perforation (SIP), necrotizing enterocolitis (NEC)-related perforation, NEC without perforation or no NEC/perforation.

STUDY DESIGN:

Retrospective cohort study of 17,426 infants admitted to Canadian neonatal intensive care units during 2010 to 2013. The primary outcome was a composite of mortality or morbidity (bronchopulmonary dysplasia, severe retinopathy, periventricular leukomalacia or nosocomial infection). Association of intestinal perforation with neonatal outcome was evaluated using multivariate logistic regression.

RESULT:

SIP was present in 178 (1.0%) infants, NEC-related perforation in 246 (1.4%) and NEC without perforation in 538 (3.1%). Any intestinal perforation was associated with higher odds of the composite outcome (adjusted odds ratio (AOR): 8.21, 95% confidence interval (95% CI) 6.26 to 10.8); however, the odds were significantly lower for focal/SIP compared with NEC-related perforation (AOR: 0.29, 95% CI 0.17 to 0.51).

CONCLUSION:

Of the two types of intestinal perforation, NEC-related perforation was associated with the highest risk of an adverse neonatal outcome.

PMID:
25927271
DOI:
10.1038/jp.2015.41
[Indexed for MEDLINE]

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