Early regional splanchnic oxygen saturation and the development of necrotizing enterocolitis in preterm infants...

Regional splanchnic oxygen saturation (r_sSO₂) is lower in preterm infants <28 weeks of gestation, who later develop necrotizing enterocolitis (NEC). Evidence is lacking for preterm infants born between 28 and 32 weeks. We aimed to investigate whether patterns of r_sSO₂ in the first week after birth differ between preterm infants who later developed NEC and matched controls with a gestational age between 28 and 32 weeks or >32 weeks and a birth weight <1200 g.

We included infants with a gestational age between 28 and 32 weeks or >32 weeks and a birth weight <1200 g. NEC infants (Bell's stage ≥2) were matched with three controls, by birth weight. We measured a daily 2-hour r_sSO₂ and calculated the mean value, coefficients of variation of r_sSO₂ (r_sCoVAR), and splanchnic-cerebral oxygenation ratio (SCOR) in the first week after birth.

We included 13 NEC infants (Bell's stage ≥2) and 39 controls, out of 190 infants. Baseline characteristics and mean r_sSO₂ were similar between cases and controls. On day seven after birth, SCOR was higher (0.65 [IQR 0.47-0.89] vs. 0.47 [0.35-0.65], P = 0.029) and r_sCoVAR was lower (0.10 [0.06-0.23] vs. 0.23 [0.14-0.26], P = 0.013) in infants who later developed NEC than in controls.

Preterm infants with a gestational age between 28 and 32 weeks or >32 weeks and a birth weight <1200 g, who developed NEC, had a higher SCOR and lower r_sCoVAR than matched controls on day seven after birth. These results suggest a different pathophysiology of NEC in this preterm group than preterm infants <28 weeks of gestation.