Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis

Area of Science:

• Neonatal immunology
• Pediatric critical care medicine

Background:

• Necrotizing enterocolitis (NEC) is a critical gastrointestinal condition in neonates.
• Peripheral cell abnormalities are noted in NEC, but gestational age-specific complete blood count (CBC) differentials are understudied.

Purpose of the Study:

• To investigate gestational age-specific immune abnormalities in NEC using comprehensive CBC differential analysis.
• To identify potential CBC markers for differentiating medical NEC from surgical NEC and predicting surgical intervention needs.

Main Methods:

• Retrospective analysis of CBC data from 246 neonates (177 NEC cases, 69 controls) admitted to NICU.
• Infants categorized by gestational age (<33 weeks and ≥33 weeks) and NEC type (medical NEC and surgical NEC).
• Machine learning models developed using CBC data for diagnostic prediction.

Main Results:

• At NEC onset, surgical NEC infants <33 weeks showed decreased monocytes and lymphocytes with increased bands compared to medical NEC.
• Both medical and surgical NEC infants ≥33 weeks exhibited a neutrophil decrease at diagnosis.
• Post-antibiotic completion, monocytes increased in surgical NEC <33 weeks, while bands decreased in surgical NEC ≥33 weeks.

Conclusions:

• Distinct leukocyte patterns in NEC are associated with gestational age.
• CBC differentials at diagnosis may aid in identifying NEC patients requiring surgery.
• Machine learning models accurately predicted surgical NEC from medical NEC and controls.