Early regional splanchnic oxygen saturation and the development of necrotizing enterocolitis in preterm infants 28-32 weeks of gestation.

BACKGROUND

Regional splanchnic oxygen saturation (rsSO2) 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 rsSO2 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.

METHODS

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 rsSO2 and calculated the mean value, coefficients of variation of rsSO2 (rsCoVAR), and splanchnic-cerebral oxygenation ratio (SCOR) in the first week after birth.

RESULTS

We included 13 NEC infants (Bell's stage ≥2) and 39 controls, out of 190 infants. Baseline characteristics and mean rsSO2 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 rsCoVAR 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.

CONCLUSION

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 rsCoVAR 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.