Table 1.
Demographic and clinical data.
| Sample size | Combined | Medical non-fulminant NEC | Surgical non-fulminant NEC | Fulminant NEC | P1 value Ful vs. SNF | P2 Ful vs. MNF | P3 MNF vs. SNF | |
|---|---|---|---|---|---|---|---|---|
| N = 336 | N = 138 | N = 163 | N = 35 | |||||
| Maternal information | ||||||||
| Pregnancy-induced hypertension, n (%) | 319 | 62 (19.4) | 20 (15.3) | 36 (23.4) | 6 (17.6) | 0.21 | ||
| Chorioamnionitis, n (%) | 308 | 24 (7.7) | 8 (6.0) | 13 (9.0) | 3 (9.0) | 0.59 | ||
| Antenatal steroids, n (%) | 315 | 175 (55.6) | 57 (44.5) | 101 (65.2) | 17 (53.1) | 0.002 | <0.001 | |
| Demographic data | ||||||||
| Gestational age (weeks; mean ± SD) | 336 | 27.9 (4.0) | 28.3 (25; 30.6) | 26.5 (24.5; 28.4) | 26.5 (25.4; 29.5) | 0.359 | 0.288 | 0.001 |
| Birth weight (g; mean ± SD) | 336 | 1087 (745) | 1035 (710; 1635) | 740 (622; 990) | 917 (708; 1158) | 0.036 | 0.227 | <0.001 |
| Mode of delivery | 335 | 0.85 | ||||||
| C-section, n (%) | 224 (66.9) | 94 (68.6) | 107 (65.6) | 23 (65.7) | ||||
| Vaginal, n (%) | 111 (33.1) | 43 (31.4) | 56 (34.4) | 12 (34.3) | ||||
| Gender—Male, n (%) | 336 | 190 (56.5) | 71 (51.4) | 101 (62.0) | 18 (51.4) | 0.15 | ||
| Race | 331 | 0.12 | ||||||
| African-American, n (%) | 242 (73.1) | 92 (68.1) | 124 (77.0) | 26 (74.3) | ||||
| Caucasian, n (%) | 70 (21.1) | 33 (24.4) | 32 (19.9) | 5 (14.3) | ||||
| Other, n (%) | 19 (5.74) | 10 (7.41) | 5 (3.1) | 4 (11.4) | ||||
| AGA (appropriate for gestational age) | 325 | 0.29 | ||||||
| No, n (%) | 230 (70.8) | 99 (75.6) | 109 (67.7) | 22 (66.7) | ||||
| Yes, n (%) | 95 (29.2) | 32 (24.4) | 52 (32.3) | 11 (33.3) | ||||
| Apgar score <6 at 5 mins, n (%) | 288 | 62 (21.5) | 21 (20.8) | 34 (21.5) | 7 (24.1) | 0.92 | ||
| Outborn, n (%) | 286 | 163 (57.0) | 52 (51.5) | 94 (59.9) | 17 (60.7) | 0.37 | ||
| NEC features | ||||||||
| Clinical presentation | 336 | <0.001 | 0.013 | <0.001 | ||||
| Abdominal distension, n (%) | 262 (78.0) | 83 (60.1) | 149 (91.4) | 30 (85.7) | ||||
| Bloody stools, n (%) | 59 (17.6) | 45 (32.6) | 9 (5.52) | 5 (14.3) | ||||
| Feeding intolerance, n (%) | 15 (4.4) | 10 (7.2) | 5 (3.0) | 0 (0.0) | ||||
| NEC age onset (days), n (%) | 333 | 21.2 (18.8) | 23.2 (17.1) | 20.3 (20.9) | 17.5 (14.6) | 0.193 | 0.05 | |
| Pneumatosis, n (%) | 246 | 104 (42.3) | 43 (42.2) | 50 (40.7) | 11 (52.4) | 0.603 | ||
| Portal venous gas, n (%) | 294 | 26 (8.8) | 2 (1.82) | 18 (11.8) | 6 (18.8) | 0.002 | 0.005 | |
| Pneumoperitoneum, n (%) | 294 | 93 (31.6) | 5 (4.55) | 78 (51.3) | 10 (31.2) | 0.06 | <0.001 | <0.001 |
| Clinical information | ||||||||
| PDA before NEC onset, n (%) | 293 | 147 (50.2) | 45 (43.3) | 94 (58.8) | 8 (27.6) | 0.004 | 0.02 | |
| Cyclooxygenase inhibitors, n (%) | 265 | 45 (17.0) | 15 (15.3) | 28 (20.0) | 2 (7.4) | 0.27 | ||
| PDA surgical ligation, n (%) | 266 | 13 (4.8) | 4 (3.8) | 9 (6.6) | 0 (0.0) | 0.39 | ||
| Inotrope use at 24 h after NEC onset, n (%) | 277 | 147 (53.1) | 20 (20.4) | 103 (67.8) | 24 (88.9) | 0.04 | <0.001 | <0.001 |
| CRP at NEC onset, median (IQR) | 207 | 2.6 [0.8; 7.4] | 1.2 [0.5; 3.5] | 4.9 [1.4; 8.5] | 3.3 [1.3; 7.0] | 0.009 | <0.001 | |
| CRP at 24 h after NEC onset, median (IQR) | 175 | 6.2 [1.4; 15.1] | 1.8 [0.6; 6.7] | 12.6 [2.9; 19.8] | 6.4 [3.9; 18.9] | 0.011 | <0.001 | |
| CRP at 48 h after NEC onset, median (IQR) | 150 | 6.6 [1.4; 18.0] | 1.7 [0.7; 6.5] | 15.4 [4.5; 21.9] | 8.8 [3.3; 12.5] | 0.032 | <0.001 | |
| Assisted ventilation at the NEC onset intubated, n (%) | 197 (74.3) | 38 (41.8) | 136 (91.3) | 23 (92.0) | <0.001 | <0.001 | ||
| Hematocrit before NEC onset, median (IQR) | 224 | 34.2 [29.8; 41.6] | 36.4 [28.8; 42.7] | 33.9 [30.2; 39.8] | 35.0 [29.6; 45.3] | 0.77 | ||
| Positive blood culture at NEC onset, n (%) | 276 | 69 (25.0) | 20 (20.2) | 44 (28.4) | 5 (22.7) | 0.32 | ||
| Antibiotics duration, median (IQR) | 213 | 7.00 [5.00; 10.0] | 7.00 [5.00; 8.00] | 10.0 [7.00; 12.0] | 2.50 [1.75; 3.00] | <0.001 | <0.001 | <0.001 |
| Cholestasis at NEC onset, n (%) | 226 | 100 (44.2) | 19 (19.6) | 78 (68.4) | 3 (20.0) | 0.001 | <0.001 | |
| Feeding before NEC onset | ||||||||
| Breast milk, n (%) | 336 | 85 (25.3) | 1 (0.72) | 73 (44.8) | 11 (31.4) | <0.001 | <0.001 | |
| Donor milk, n (%) | 336 | 38 (11.3) | 3 (2.17) | 30 (18.4) | 5 (14.3) | 0.009 | <0.001 | |
| Formula feed, n (%) | 336 | 32 (9.5) | 15 (10.9) | 13 (7.9) | 4 (11.4) | 0.61 | ||
| Mixed feeding, n (%) | 336 | 25 (7.4) | 9 (6.5) | 16 (9.8) | 0 (0.0) | 0.11 | ||
| Length of hospitalization median (IQR) | 275 | 102 [48.0; 152] | 76.0 [40.0; 111] | 124 [83.0; 179] | 17.5 [3.00; 29.2] | <0.001 | <0.001 | |
| Death | 321 | <0.001 | <0.001 | <0.001 | ||||
| Death, n (%) | 85 (26.5) | 10 (8.06) | 40 (24.7) | 35 (100) | ||||
| Discharged, n (%) | 236 (73.5) | 114 (91.9) | 122 (75.3) | 0 (0.00) | ||||
Data are represented as n (%), mean (SD), or median (1st quartile, 3rd quartile). Differences in continuous measures were tested using a t-test or Mann–Whitney U test, ANOVA or Kruskal–Wallis test; differences in categorical measures were tested using a chi-square test or Fisher’s exact test; P1 = fulminant vs. surgical non-fulminant (SNF), P2 = fulminant (ful) vs. medical non-fulminant (MNF), P3 = MNF vs. SNF.
Statistically significant p < 0.05 values are in bold.
CRP C-reactive protein, PDA patent ductus arteriosus.