Table 1 :
Clinical and demographic characteristics of cohort of neonates with surgical NEC from 2013–2018
| N | All | WMBI N=36 |
No WMBI N=33 |
p value | |
|---|---|---|---|---|---|
| Prenatal Information | |||||
| Pregnancy-Induced Hypertension, n (%) | 69 | 18 (26.1) | 9 (25.0) | 9 (27.3) | 0.830 |
| Chronic Hypertension, n (%) | 62 | 11 (17.7) | 4 (12.1) | 7 (24.1) | 0.319 |
| Chorioamnionitis, n (%) | 69 | 8 (11.6) | 3 (8.3) | 5 (15.2) | 0.466 |
| Antenatal Steroids, n (%) | 68 | 53 (77.9) | 30 (83.3) | 23 (71.9) | 0.255 |
| Infant Demographics | |||||
| Gestational Age (weeks); (mean ± SD) | 69 | 26.5 (2.7) | 25.9 (2.1) | 27.1 (3.2) | 0.139 |
| Birth Weight (grams); (mean ± SD) | 69 | 927 (484) | 858 (300) | 1002 (623) | 0.862 |
| Small for Gestational Age, n (%) | 68 | 20 (29.4) | 5 (14.3) | 15 (45.5) | 0.005 |
| Male Gender, n (%) | 69 | 46 (66.7) | 23 (63.9) | 23 (69.7) | 0.609 |
| Race, n (%) | 69 | 0.359 | |||
| Caucasian | 12 (17.4) | 6 (16.7) | 6 (18.2) | ||
| Latino | 2 (2.9) | 0 (0.0) | 2 (6.1) | ||
| African American | 53 (76.8) | 28 (77.8) | 25 (75.8) | ||
| Other | 2 (2.9) | 2 (5.6) | 0 (0.0) | ||
| Mode of Delivery, n (%) | 69 | 0.096 | |||
| C-section | 49 (71.0) | 22 (61.1) | 27 (81.2) | ||
| Vaginal | 20 (29.0) | 14 (38.9) | 6 (18.2) | ||
| Apgar Score <6 at 5 Minutes, n (%) | 69 | 20 (29.0) | 10 (27.8) | 10 (30.3) | 0.817 |
| Outborn, n (%) | 69 | 42 (60.9) | 20 (55.6) | 22 (66.7) | 0.345 |
| Infant Medical Information Prior to NEC | |||||
| Patent Ductus Arteriosus, n (%) | 69 | 44 (63.8) | 25 (69.4) | 19 (57.6) | 0.306 |
| Patent Ductus Arteriosus, Indomethacin, n (%) | 69 | 9 (13.0) | 7 (19.4) | 2 (6.1) | 0.154 |
| Platelet Transfusion Before NEC, n (%) | 69 | 49 (72.0) | 26 (72.2) | 23 (69.7) | 0.817 |
| Red blood Cell Transfusion Before NEC, n (%) | 56 | 16 (28.6) | 14 (41.2) | 2 (9.1) | 0.009 |
| NEC Disease Features | |||||
| Clinical Presentation, n (%) | 69 | 0.615 | |||
| Abdominal Distension | 64 (92.8) | 32 (88.9) | 32 (97.0) | ||
| Bloody Stools | 3 (4.3) | 2 (5.6) | 1 (3.0) | ||
| Feeding Intolerance | 2 (2.9) | 2 (5.6) | 0 (0.0) | ||
| Radiological Findings, n (%) | |||||
| Pneumatosis | 69 | 27 (39.1) | 11 (30.6) | 16 (48.5) | 0.127 |
| Pneumoperitoneum | 69 | 39 (56.5) | 25 (69.4) | 14 (42.4) | 0.024 |
| Portal Venous Gas | 69 | 3 (4.3) | 2 (5.6) | 1 (3.0) | 1.000 |
| Age of NEC Onset (days); (mean ± SD) (median [IQR]) |
69 | 17.4 (15.9) 11 [6–24] |
13.4 (14.8) 8.5 [4.5–14] |
21.6 (16.3) 16 [8–31] |
0.008 |
| Penrose Drain Present, n (%) | 65 | 28 (43.1) | 16 (44.4) | 12 (41.4) | 0.643 |
| Surgery Timing | |||||
| Surgery < 48 Hours, n (%) | 64 | 43 (67.2) | 25 (71.4) | 18 (62.1) | 0.427 |
| Surgery > 48 Hours, n (%) | 64 | 21 (32.8) | 10 (28.6) | 11 (37.9) | 0.427 |
| Length of Bowel Resected (cm; mean ± SD) | 67 | 20.9 (21.4) | 22.0 (21.1) | 19.6 (22.0) | 0.712 |
| Region of Bowel Resected, n (%) | 64 | 0.136 | |||
| Small Bowel Resected | 42 (65.6) | 25 (71.4) | 17 (58.6) | ||
| Large Bowel Resected | 2 (3.1) | 2 (5.7) | 0 (0.0) | ||
| Combined Large and Small Bowel Resected | 20 (31.3) | 8 (22.9) | 12 (41.4) | ||
| Ileocecal Valve Present, n (%) | 68 | 49 (72.1) | 26 (72.2) | 23 (71.9) | 0.673 |
| Type of Stoma | 66 | 0.247 | |||
| Ileostomy, n (%) | 39 (56.5) | 23 (63.9) | 16 (48.5) | ||
| Colostomy, n (%) | 3 (4.3) | 1 (2.8) | 2 (6.1) | ||
| Jejunostomy, n (%) | 21 (30.4) | 9 (25.0) | 12 (36.4) | ||
| Combined Stoma, n (%) | 3 (4.3) | 3 (8.3) | 0 (0.0) | ||
| Short Bowel Syndrome, n (%) | 60 | 34 (56.7) | 19 (59.4) | 15 (53.6) | 0.455 |
| Surgical Morbidity (Infection, Adhesions, Strictures, Dehiscence), n (%) | 69 | 27 (39.1) | 12 (33.3) | 15 (45.5) | 0.302 |
| Post-Operative Intestinal Features | |||||
| Post-Operative Ileus Days (days); (median [IQR]) |
66 | 13 [9–16] | 14 [11–20] | 11 [8–14] | 0.031 |
| Post-Operative Day at Starting Enteral Feedings (days); (median [IQR]) |
65 | 14 [10–18] | 14 [13–20] | 12 [8.5–15.5] | 0.039 |
| Day Attainment of Full Enteral Feedings (120 mL/kg); (median [IQR]) |
61 | 69 [30–89] | 74.5 [30–107] | 61 [27–79] | 0.094 |
| Duration of Parenteral Nutrition (days); (median [IQR]) |
69 | 97 [65–137] | 116 [71.5–159] | 86 [58–117] | 0.071 |
| Post-Operative Systemic Course | |||||
| Assisted Ventilation (intubated), n (%) | 67 | 59 (88.1) | 30 (85.7) | 29 (90.6) | 0.711 |
| 24h Ionotropic Support, n (%) | 68 | 52 (76.5) | 27 (75.0) | 25 (78.1) | 0.762 |
| AKI by Serum Creatinine, n (%) | 61 | 0.027 | |||
| Normal | 29 (47.5) | 15 (48.4) | 14 (46.7) | ||
| Stage 1 | 12 (19.7) | 10 (32.3) | 2 (6.7) | ||
| Stage 2 | 9 (14.8) | 2 (6.5) | 7 (23.3) | ||
| Stage 3 | 11 (18.0) | 4 (12.9) | 7 (23.3) | ||
| AKI by Urine Output, n (%) | 61 | 0.564 | |||
| Normal | 35 (57.4) | 20 (64.5) | 15 (50.0) | ||
| Stage 1 | 2 (3.3) | 1 (3.2) | 1 (3.3) | ||
| Stage 2 | 17 (27.9) | 8 (25.8) | 9 (30.0) | ||
| Stage 3 | 7 (11.5) | 2 (6.5) | 5 (16.7) | ||
| Sepsis Variables | |||||
| Central Line Present (days; mean ± SD) | 66 | 63.5 (41.6) | 67.0 (46.2) | 59.5 (36.0) | 0.812 |
| Positive Blood Culture Sepsis, n (%) | 69 | 24 (34.8) | 13 (36.1) | 11 (33.3) | 0.809 |
| Gram Positive Sepsis, n (%) | 69 | 13 (18.8) | 8 (22.2) | 5 (15.2) | 0.453 |
| Gram Negative Sepsis, n (%) | 69 | 8 (11.6) | 4 (11.1) | 4 (12.1) | 1.000 |
| Positive Blood Culture Sepsis 7 Days after NEC Diagnosis to Discharge, n (%) | 26 | 7 (26.9) | 2 (14.3) | 5 (41.7) | 0.658 |
| CRP on Day of NEC Onset (mean ± SD) | 58 | 7.7 (8.9) | 6.6 (8.3) | 9.0 (9.6) | 0.072 |
| CRP at 1 Week after NEC Onset (mean ± SD) | 47 | 7.9 (9.3) | 8.4 (10.6) | 7.4 (8.4) | 0.822 |
| Cholestasis at NEC Onset, n (%) | 66 | 44 (66.7) | 24 (68.6) | 20 (64.5) | 0.164 |
| BPD, n (%) | 61 | 53 (86.9) | 30 (93.8) | 23 (79.3) | 0.026 |
| Postnatal Use of Steroids, n (%) | 69 | 42 (60.9) | 26 (72.2) | 16 (48.5) | 0.044 |
| Discharge | |||||
| Length of Stay (days); (median [IQR]) |
69 | 161 [109–186] | 173.5 [123–205.5] | 133 [94–171] | 0.038 |
| Death, n (%) | 69 | 6 (8.7) | 4 (11.1) | 2 (6.1) | 0.675 |
Abbreviations: NEC = Necrotizing Enterocolitis; AKI = Acute kidney Injury, CRP = C -reactive protein, WMBI (white matter Brain injury)
Categorical variables are presented as count (column percentage). Continuous variables are presented as mean (standard deviation) and, if not normally distributed, as median with interquartile range. If normality criteria were satisfied, differences in continuous measures’ statistical associations with WMA were tested using a t-test for equal or Welch t-test for unequal variances. When the normality assumption was not satisfied, continuous measures’ statistical associations with WMA were tested with the Kruskal-Wallis Test. Differences in categorical measures’ associations with WMA were tested using the Chi-square test when cell counts were adequate, otherwise Fisher’s Exact and Fisher-Freeman-Halton (FFH) were used with low expected cell counts. All tests were two-sided.