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Author Spotlight: Enhancing Understanding and Treatment Strategies with the NEC-on-a-Chip Model
Published on: July 28, 2023
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Can a national dataset generate a nomogram for necrotizing enterocolitis onset?
P V Gordon1, R Clark2, J R Swanson3
11] Department of Pediatrics, Sacred Heart Women's and Children's Hospital, Pensacola, FL, USA [2] Pediatrix Corporation, Sunrise, FL, USA.
Summary
Necrotizing enterocolitis (NEC) onset is inversely related to gestational age at birth. Medical NEC is the most reliable indicator for understanding NEC risk timing.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Clinical Epidemiology
Background:
- Mother's own milk and donor milk are increasingly used for necrotizing enterocolitis (NEC) prevention.
- Early enteral feeding may improve outcomes but has not been proven to reduce NEC incidence.
- Defining NEC risk windows by gestational age is crucial for resource management and understanding pathogenesis.
Purpose of the Study:
- To build a generalizable model of NEC onset using a large national dataset.
- To establish a NEC dataset of sufficient size and quality for analysis.
- To define the window of NEC risk across different gestational strata.
Main Methods:
- Utilized de-identified data from the Pediatrix national dataset.
- Filtered for NEC and spontaneous intestinal perforation (SIP) as outcomes, excluding diagnostic confounders.
- Analyzed the median day of onset against gestational age for NEC and SIP.
Main Results:
- Medical NEC onset showed a linear inverse relationship with gestational age.
- Medical NEC data suggested a homogeneous disease entity.
- Surgical NEC presented earlier in younger gestations, indicating potential SIP contamination.
Conclusions:
- NEC onset is stereotypic and linearly inversely related to gestational age at birth.
- Medical NEC is the most reliable sub-cohort for temporal risk assessment.
- Understanding NEC timing aids in resource allocation and pathogenesis research.
