Dataset Information

Correlative Factors of the Deterioration of Necrotizing Enterocolitis in Small for Gestational Age Newborns.

ABSTRACT: Small for gestational age (SGA) infants have an increased risk of necrotizing enterocolitis (NEC), but SGA has been found to not be a risk factor for the deterioration of NEC in previous literature. Few studies have focused on correlative factors of the progression of NEC in SGA newborns. The present retrospective observational study was performed in 64 SGA infants with Bell's stage II NEC. The dependent variable was Bell's stage II NEC that progressed to stage III after diagnosis. A stepwise forward multivariate logistic regression model was used to select potential correlative factors for the progression of NEC in SGA newborns. The results showed that elevation of CRP after NEC diagnosis (aOR 39.21, 95% CI 6.62-249.2) has an increased risk for deteriorating Bell's stage II NEC. In contrast, NEC in infants with congenital heart disease had a decreased risk of deterioration (aOR 0.11, 95% CI 0.01-0.92). Our findings indicated that serial CRP measurements post NEC diagnosis may be useful in predicting the deterioration of NEC.

SUBMITTER: Luo L

PROVIDER: S-EPMC5758570 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Correlative Factors of the Deterioration of Necrotizing Enterocolitis in Small for Gestational Age Newborns.

Luo Lijuan L Dong Wenbin W Zhang Lingping L Zhai Xuesong X Li Qingping Q Lei Xiaoping X

Scientific reports 20180108 1

Small for gestational age (SGA) infants have an increased risk of necrotizing enterocolitis (NEC), but SGA has been found to not be a risk factor for the deterioration of NEC in previous literature. Few studies have focused on correlative factors of the progression of NEC in SGA newborns. The present retrospective observational study was performed in 64 SGA infants with Bell's stage II NEC. The dependent variable was Bell's stage II NEC that progressed to stage III after diagnosis. A stepwise fo ...[more]

PMID: 29311572

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Project description:ObjectiveTo identify the prevalence, risk factors and health impacts associated with small for gestational age (SGA) births in Nepal.MethodsA cross-sectional study was conducted in 12 public hospitals in Nepal from 1 July 2017 to 29 August 2018. A total of 60 695 babies delivered in these hospitals during the study period were eligible for inclusion. Clinical information of mothers and newborns was collected by data collectors using a data retrieval form. A semistructured interview was conducted at the time of discharge to gather sociodemographic information from women who provided the consent (n=50 392). Babies weighing less than the 10th percentile for their gestational age were classified as SGA. Demographic, obstetric and neonatal characteristics of study participants were analysed for associations with SGA. The association between SGA and likelihood of babies requiring resuscitation or resulting in stillbirth and neonatal death was also explored.ResultsThe prevalence of SGA births across the 12 hospitals observed in Nepal was 11.9%. After multiple variable adjustment, several factors were found to be associated with SGA births, including whether mothers were illiterate compared with those completing secondary and higher education (adjusted OR (AOR)=1.73; 95% CI 1.09 to 2.76), use of polluted fuel compared with use of clean fuel for cooking (AOR=1.51; 95% CI 1.16 to 1.97), first antenatal care (ANC) visit occurring during the third trimester compared with first trimester (AOR=1.82; 95% CI 1.27 to 2.61) and multiple deliveries compared with single delivery (AOR=3.07; 95% CI 1.46 to 6.46). SGA was significantly associated with stillbirth (AOR=7.30; 95% CI 6.26 to 8.52) and neonatal mortality (AOR=5.34; 95% CI 4.65 to 6.12).ConclusionsLow literacy status of mothers, use of polluted fuel for cooking, time of first ANC visit and multiple deliveries are associated with SGA births. Interventions encouraging pregnant women to attend ANC visits early can reduce the burden of SGA births.

Project description:Background: Small for gestational age (SGA) is a key contributor to premature deaths and long-term complications in life. Improved characterization of maternal risk factors associated with this adverse outcome is needed to inform the development of interventions, track progress, and reduce the disease burden. This study aimed to identify socioeconomic, demographic, and clinical factors associated with SGA in Mexico. Methods: We analyzed administrative data from 1,841,477 singletons collected by the National Information Subsystem of Livebirths during 2017. Small-for-gestational-age was defined as being <10th centiles according to the INTERGROWTH-21st standards. The comparison group was defined as being in ≥10th centiles. We fitted logistic regression models to determine odds ratios for the maternal factors associated with SGA. Results: Among the 1,841,477 singletons, 51% were male, 6.7% were SGA, 6.1% were term-SGA, and 0.5% were preterm-SGA. Maternal education presented a protective gradient of being SGA among mothers who achieved 1 to 6 years of education (adjusted odds ratio (aOR)0.95; 95% CI:0.91,0.99), 7 to 9 years (aOR 0.86; 95% CI:0.83,0.89), 10 to 12 years (aOR 0.75; 95% CI: 0.72, 0.79) and > 12 years (aOR 0.63; 95% CI:0.6,0.66) compared with those without education. SGA was particularly likely to occur among primiparous (aOR 1.42; 95% CI: 1.39, 1.43), mothers living in very high deprivation localities (aOR 1.39; 95% CI: 1.36, 1.43), young (aOR 1.04; 95% CI: 1.02, 1.06), advanced age (aOR 1.14; 95% CI 1.09, 1.19), and mothers living in areas above 2,000 m (aOR 1.69; 95% CI: 1.65, 1.73). Antenatal care was associated with a reduced risk of SGA by 30% (aOR 0.7; 95% CI:0.67,0.73), 23% (OR 0.77; 95% CI:0.74,0.8), and 21% (OR 0.79; 95% CI:0.75,0.83), compared with those mothers who never received antenatal care, when women visited the clinic at the first, second and third trimester, respectively. Conclusion: Almost 7% of live births were found to be SGA. Parity, maternal age, education, place of residence, and social deprivation were significantly associated with this outcome. Antenatal care was protective. These findings imply that interventions focusing on early and adequate contact with health care facilities, reproductive health counseling, and maternal education should reduce SGA in Mexico.

Dataset Information

Correlative Factors of the Deterioration of Necrotizing Enterocolitis in Small for Gestational Age Newborns.

Publications

Correlative Factors of the Deterioration of Necrotizing Enterocolitis in Small for Gestational Age Newborns.

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