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Updated: Jul 14, 2025

A Neonatal BALB/c Mouse Model of Necrotizing Enterocolitis
Published on: November 30, 2021
Cholestasis is associated with a higher rate of complications in both medical and surgical necrotizing enterocolitis
Sujir Pritha Nayak1, Katie A Huff2, Isabella Zaniletti3
1University of Texas Southwestern Medical Center, Dallas, TX, USA. pritha.nayak@utsouthwestern.edu.
Objective:
To evaluate the relationship between cholestasis and outcomes in medical and surgical necrotizing enterocolitis (NEC).
Study Design:
A retrospective analysis of prospectively collected data from 1472 infants with NEC [455 medical (mNEC) and 1017 surgical (sNEC)] from the Children's Hospital Neonatal Database.
Results:
The prevalence of cholestasis was lower in mNEC versus sNEC (38.2% vs 70.1%, p < 0.001). In both groups, cholestasis was associated with lower birth gestational age [mNEC: OR 0.79 (95% CI 0.68-0.92); sNEC: OR 0.86 (95% CI 0.79-0.95)] and increased days of parenteral nutrition [mNEC: OR 1.08 (95% CI 1.04-1.13); sNEC: OR 1.01 (95% CI 1.01-1.02)]. For both groups, the highest direct bilirubin was associated with the composite outcome mortality or length of stay >75th percentile [mNEC: OR 1.21 (95% CI 1.06-1.38); sNEC: OR 1.06 (95% CI 1.03-1.09)].
Conclusion:
Cholestasis with both medical NEC and surgical NEC is associated with adverse patient outcomes including increased mortality or extreme length of stay.
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