Gestational age-specific hematological features in preterm infants with necrotizing enterocolitis

Area of Science:

• Neonatalogy
• Pediatric Surgery
• Hematology

Background:

• Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in preterm infants.
• Understanding gestational age-specific hematological features is crucial for managing NEC.
• Identifying biomarkers for surgical NEC can improve patient outcomes.

Purpose of the Study:

• To investigate gestational age-specific hematological features in preterm infants diagnosed with NEC.
• To identify predictive hematological biomarkers that distinguish between medical NEC (m-NEC) and surgical NEC (s-NEC).

Main Methods:

• Retrospective study comparing clinical data of m-NEC and s-NEC subgroups.
• Infants stratified by gestational age (GA): <28 weeks, 28–31 weeks, and 32–36 weeks.
• Multivariate logistic analysis and ROC curves used to identify predictors of s-NEC.

Main Results:

• Infants with s-NEC showed lower platelet counts (GA <28 weeks).
• Lower absolute lymphocyte counts and significant drops in platelets, lymphocytes, and monocytes observed (28–31 weeks GA).
• Lower absolute lymphocyte counts and lymphocyte drop noted (32–36 weeks GA). Platelet count (GA <28 weeks) and C-reactive protein (28–31 weeks GA) showed high AUCs (0.880 and 0.889, respectively). Lymphocyte count (32–36 weeks GA) had an AUC of 0.892.

Conclusions:

• Hematological abnormalities in NEC development are dependent on gestational age.
• Specific hematological parameters serve as independent predictors for distinguishing s-NEC from m-NEC.
• These findings support the development of GA-based diagnostic strategies for early surgical NEC identification.