Association of Surgical Necrotizing Enterocolitis and its Timing with Retinopathy of Prematurity

Jennifer B. Fundora, Gil Binenbaum, Lauren Tomlinson, Yinxi Yu, Gui Shuang Ying, Akhil Maheshwari, Pamela Donohue

Research output: Contribution to journalArticlepeer-review

Abstract

Objective The study aimed to determine the association of surgical necrotizing enterocolitis (NEC) and its timing, with the development and timing of retinopathy of prematurity (ROP). Study Design This was a secondary data analysis of 7,483 preterm infants from the Postnatal Growth and Retinopathy of Prematurity Study. Associations between infants with surgical NEC, early-onset surgical NEC (8-28 days), and late-onset surgical NEC (over 28 days) with ROP were evaluated by using multivariable logistic regression models, controlling for birth weight, gestational age, small for gestational age status, chronic lung disease, intraventricular hemorrhage, hydrocephalus, patent ductus arteriosus, and periventricular leukomalacia. Results Three hundred fifty-six (4.8%) infants had surgical NEC, with 56% having early surgical NEC. Infants with surgical NEC had a higher risk of any ROP and severe ROP (adjusted odds ratio [OR]: 2.7; 95% CI: 1.9-3.7) and 2.5 (95% CI: 1.9-3.3), respectively; p < 0.001) compared with infants without surgical NEC. Infants with early surgical NEC were at the highest risk of developing ROP and severe ROP (adjusted OR: 3.1 [95% CI: 2.1-4.8], and 3.3 [95% CI: 2.3-4.7] respectively, p < 0.001). Infants with late surgical NEC were also at increased risk of developing ROP and severe ROP (adjusted OR: 2.1 [95% CI: 1.3-3.4], and 1.9 [95% CI: 1.3-2.8] respectively, p < 0.001) compared with infants without surgical NEC. Conclusion Infants with surgical NEC, especially early surgical NEC, are at higher risk of ROP and severe ROP. Key Points Infants with surgical NEC are at higher risk of ROP and severe ROP than those without surgical NEC. Increased ROP risk is seen in infants with both early- or later onset surgical NEC. Early-onset surgical NEC is associated with a higher ROP risk compared with later onset surgical NEC.

Original languageEnglish (US)
JournalAmerican journal of perinatology
DOIs
StateAccepted/In press - 2021

Keywords

  • intestinal injury
  • necrotizing enterocolitis
  • neonate
  • prematurity
  • retinopathy of prematurity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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