Related Experiment Video
Updated: May 11, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Superior mesenteric artery Doppler is poor at predicting feed intolerance and NEC in preterm small for gestational
Deepak Louis1, Kanya Mukhopadhyay, Kushaljit Singh Sodhi
1Neonatal Unit, Department of Pediatrics .
Objective:
To study SMA Doppler for predicting feed intolerance and necrotizing enterocolitis (NEC) in preterm SGA neonates with umbilical artery absent/reversed end diastolic flow (A/REDF).
Study Design:
Prospective study.
Patients:
SGA neonates <36 weeks born with antenatally diagnosed A/REDF formed cases. Those with normal Doppler formed controls. Primary outcomes were feed intolerance and NEC. Peak systolic velocity, end diastolic velocity (EDV), time-averaged mean velocity, pulsatility index and resistive index (RI) were measured in SMA Doppler done postnatally on days 1 and 5.
Results:
Fifty neonates were enrolled in each group. Gestation, birth weight, gender and Apgar scores were comparable. Feed intolerance rate was similar (A/REDF: 26% versus controls: 20%, p 0.48), NEC was commoner in A/REDF group (32% versus 4%, p < 0.001). Baseline SMA Doppler indices were similar; RI on day 1 was higher in babies with A/REDF [5.4 (IQR 3.3, 7.3)] who developed NEC compared to controls [3.3 (IQR 1.7, 3.9)], (p 0.049). RI of 3.63 on day 1 had only a sensitivity of 61% and a specificity of 57% in predicting NEC in A/REDF group (area under curve (AUC) 0.61, 95% CI: 0.43-0.79, p = 0.25). Similarly, EDV of 8.7 cm/s had only a sensitivity of 61% and a specificity of 60% for the prediction of NEC (AUC of 0.64, 95% CI: 0.47-0.81, p = 0.16).
Conclusions:
Postnatal SMA Doppler indices do not predict feed intolerance and NEC in preterm SGA babies with A/REDF.
