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Nil-per-os days and necrotizing enterocolitis in extremely preterm infants
Maksim Kirtsman1, Eugene W Yoon1, Cecil Ojah2
1Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
American Journal of Perinatology
|December 30, 2014
Summary
Prolonged nil-per-os (NPO) feeding increases the risk of necrotizing enterocolitis (NEC) in extremely preterm infants. Longer NPO duration is a significant risk factor for NEC development in this vulnerable population.
Area of Science:
- Neonatal research
- Gastroenterology
- Perinatal medicine
Background:
- Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition affecting preterm infants.
- The role of feeding practices in NEC development requires further investigation.
Purpose of the Study:
- To assess the association between nil-per-os (NPO) days and the incidence of NEC in extremely preterm neonates (<29 weeks gestational age).
Main Methods:
- A case-control study involving 234 neonates with NEC and 467 matched controls from the Canadian Neonatal Network (2010-2011).
- Logistic regression was used to compare NPO days between NEC cases and controls.
Main Results:
- Infants who developed NEC had significantly more NPO days (5.6 days) compared to controls (3.7 days).
- Each additional NPO day was associated with an 8% increased adjusted odds of developing NEC (OR 1.08, 95% CI: 1.04-1.12).
- NEC cases also showed higher rates of inotropic support, antibiotic use, and patent ductus arteriosus (PDA).
Conclusions:
- Extended periods of NPO feeding are linked to a higher risk of NEC in extremely preterm infants.
- Delayed or interrupted enteral feeding may be a critical risk factor for NEC.
- These findings highlight the importance of optimizing feeding strategies in very preterm neonates.
