Affiliations: [a] Department of Pediatrics/Neonatology, University of Mississippi, Jackson, MS, USA
| [b] Department of Data Science, University of Mississippi, Jackson, MS, USA
| [c] Departments of Pathology, University of Mississippi, Jackson, MS, USA
| [d] Departments of Radiology, Children’s Mercy Hospital, Kansas City, MO, USA
| [e] Department of Medicine, University of Mississippi, Jackson, MS, USA
Correspondence:
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Address for correspondence: Parvesh M. Garg, Department of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA 39216; Tel.: +1 252 364 5800; E-mail: gargparvesh@hotmail.com.
Abstract: BACKGROUND:To determine the clinical implications and gestation age-specific diagnostic predictability of pneumatosis in preterm infants with necrotizing enterocolitis (NEC). METHODS:A retrospective study on abdominal radiographs comparing clinical and radiological information in infants with and without pneumatosis. RESULT:Our findings disproved our hypothesis. Pneumatosis was seen more frequently in infants with higher gestational age [28.4 (26.1–32.4) vs. 26.4 (24.3–29) weeks; p < 0.001] and birth weight [1110 (762–1768) vs. 770 (645–1022) grams; p < 0.001] and were more likely delivered vaginally (39.1% vs. 21.7%, p = 0.01). Portal venous gas was seen frequently on radiographs (10.3% vs. 0%, p < 0.001), but not pneumoperitoneum (20.7% vs. 36.7%, p = 0.02). Infants with pneumatosis frequently developed acute kidney injury, with higher serum creatinine (16.5% vs. 4.5%, p = 0.02) and frequent oliguria (12.9% vs. 2.7 %; p = 0.043) and had higher C-reactive protein levels at 24 and 96 hours (p < 0.002). Receiver operating curves for pneumatosis showed GA >28 weeks and birth weight > 1000 gm to have a sensitivity of 58.6% and specificity of 72.5%. CONCLUSION:Contrary to our hypothesis, infants who developed pneumatosis during NEC were more mature with a higher gestational age and birth weight than those who did not.
