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Am J Perinatol 2023; 40(11): 1178-1184
DOI: 10.1055/s-0041-1733785
Original Article

Association of Surgical Necrotizing Enterocolitis and Its Timing with Retinopathy of Prematurity

Jennifer B. Fundora 
1   Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Gil Binenbaum
2   Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
,
Lauren Tomlinson
2   Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
,
Yinxi Yu
3   Department of Ophthalmology, Center for Preventative Ophthalmology and Biostatistics, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
,
Gui-shuang Ying
3   Department of Ophthalmology, Center for Preventative Ophthalmology and Biostatistics, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
,
Akhil Maheshwari
4   Global Newborn Society, Baltimore, Maryland
,
Pamela Donohue
1   Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
5   Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
› Institutsangaben Funding This study received its financial support from U.S. Department of Health and Human Services, National Institutes of Health (NIH) grants T32HD044355, 1R01EY021137-01A1 and 1R21EY029776-01, R01 HL133022, R01 HL124078, and the Richard Shafritz Chair in Ophthalmology Research.
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Abstract

Objective The study aimed to determine the association of surgical necrotizing enterocolitis (NEC) and its timing, with the development and timing of retinopathy of prematurity (ROP).

Study Design This was a secondary data analysis of 7,483 preterm infants from the Postnatal Growth and Retinopathy of Prematurity Study. Associations between infants with surgical NEC, early-onset surgical NEC (8–28 days), and late-onset surgical NEC (over 28 days) with ROP were evaluated by using multivariable logistic regression models, controlling for birth weight, gestational age, small for gestational age status, chronic lung disease, intraventricular hemorrhage, hydrocephalus, patent ductus arteriosus, and periventricular leukomalacia.

Results Three hundred fifty-six (4.8%) infants had surgical NEC, with 56% having early surgical NEC. Infants with surgical NEC had a higher risk of any ROP and severe ROP (adjusted odds ratio [OR]: 2.7; 95% CI: 1.9–3.7) and 2.5 (95% CI: 1.9–3.3), respectively; p < 0.001) compared with infants without surgical NEC. Infants with early surgical NEC were at the highest risk of developing ROP and severe ROP (adjusted OR: 3.1 [95% CI: 2.1–4.8], and 3.3 [95% CI: 2.3–4.7] respectively, p < 0.001). Infants with late surgical NEC were also at increased risk of developing ROP and severe ROP (adjusted OR: 2.1 [95% CI: 1.3–3.4], and 1.9 [95% CI: 1.3–2.8] respectively, p < 0.001) compared with infants without surgical NEC.

Conclusion Infants with surgical NEC, especially early surgical NEC, are at higher risk of ROP and severe ROP.

Key Points

  • Infants with surgical NEC are at higher risk of ROP and severe ROP than those without surgical NEC.

  • Increased ROP risk is seen in infants with both early- or later onset surgical NEC.

  • Early-onset surgical NEC is associated with a higher ROP risk compared with later onset surgical NEC.

Keywords

necrotizing enterocolitis - retinopathy of prematurity - prematurity - intestinal injury - neonate


Publikationsverlauf

Eingereicht: 26. Oktober 2020

Angenommen: 28. Juni 2021

Artikel online veröffentlicht:
03. August 2021

© 2021. Thieme. All rights reserved.

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