A comparative study of serum and fecal calprotectin levels in necrotizing enterocolitis

Necrotizing enterocolitis is a significant cause of morbidity and mortality in premature infants. Various fecal, urinary, and serum biomarkers have all been investigated for their potential in the prediction and early detection of necrotizing enterocolitis. This pilot study aimed to explore the feasibility and clinical utility of measuring serum and fecal calprotectin levels in preterm infants with necrotizing enterocolitis.

This prospective pilot study included preterm infants born at < 32 weeks' gestation with a birth weight of ≤ 1500 g, consisting of patients diagnosed with necrotizing enterocolitis stage II or III and a randomly selected control group without necrotizing enterocolitis. The relationship between serum and fecal calprotectin concentrations and necrotizing enterocolitis severity, need for surgical intervention, and mortality was systematically analyzed.

A total of 39 necrotizing enterocolitis patients (25 with stage II, 14 with stage III) and 20 randomly selected preterm infants were included as the control group. Serum and fecal calprotectin levels were significantly higher in necrotizing enterocolitis stage III and in infants who required surgery or died (p < 0.05), indicating their potential to predict disease severity and poor outcomes.

This pilot study suggests that dual assessment of serum and fecal calprotectin may provide insight into necrotizing enterocolitis severity and outcomes. Larger studies are needed to validate these findings and determine clinical applicability.

This study was registered with the ClinicalTrials.gov database under the registration number NCT06693154 on November 15, 2024.