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Observational Study
. 2024 Jan;44(1):94-99.
doi: 10.1038/s41372-023-01782-6. Epub 2023 Sep 27.

Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age

Pavan V Thakkar  1 , Kent F Sutton  2 , Chloe-Ann B Detwiler  1 , Julia G Henegar  1 , Jai R Narayan  1 , Melanie Perez-Romero  1 , Ciara M Strausser  1 , Reese H Clark  3 , Daniel K Benjamin Jr  1   4 , Kanecia O Zimmerman  1   4 , Ronald N Goldberg  4 , Noelle Younge  4 , David Tanaka  4 , P Brian Smith  1   4 , Rachel G Greenberg  5   6 , Ryan Kilpatrick  1   4
Affiliations
Observational Study

Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age

Pavan V Thakkar et al. J Perinatol. 2024 Jan.

Abstract

Objective: To describe the epidemiology, risk factors, and timing of spontaneous intestinal perforation (SIP) among infants born at 22-24 weeks' gestational age (GA).

Study design: Observational cohort study among infants born at 22-24 weeks' GA in 446 neonatal intensive care units.

Results: We identified 9712 infants, of whom 379 (3.9%) developed SIP. SIP incidence increased with decreasing GA (P < 0.001). Antenatal magnesium (odds ratio (OR) 1.42; 95% confidence interval (CI), 1.09-1.85), antenatal indomethacin (OR 1.40; 95% CI, 1.06-1.85), postnatal indomethacin (OR 1.61; 95% CI, 1.23-2.11), and postnatal hydrocortisone exposure (OR 2.02; 95% CI 1.50-2.73) were associated with SIP. Infants who lost 15-20% (OR 1.77; 95% CI, 1.28-2.44) or >20% (OR 2.04; 95% CI, 1.46-2.85) of birth weight had higher odds of SIP than infants with weight loss <10%.

Conclusions: Antenatal magnesium exposure, antenatal indomethacin exposure, postnatal hydrocortisone exposure, postnatal indomethacin exposure, and weight loss ≥15% were associated with SIP.

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Conflict of interest statement

Pavan Thakkar, Chloe-Ann Detwiler, Julia G. Henegar, Jai Narayan, Melanie Perez-Romero, and Ciara Strausser declare support from a National Institute of Child Health and Human Development grant. Dr. Benjamin, Jr. reports consultancy for Allergan, Melinta Therapeutics, Sun Pharma Advanced Research Co. Dr. Zimmerman reports funding from the National Institutes of Health (NIH) and US Food and Drug Administration (FDA). Rachel Greenberg has received support from industry for research services (https://dcri.org/about-us/conflict-of-interest/). Kent F. Sutton, Ronald N. Goldberg, Noelle Younge, David Tanaka, P. Brian Smith, Reese Clark, and Ryan Kilpatrick have nothing to disclose.

Figures

Fig. 1
Fig. 1
Percentage of 22–24 week gestational age infants with SIP by year.
Fig. 2
Fig. 2
Occurrence of SIP among 22–24 week gestational age infants by postnatal day.
See this image and copyright information in PMC

References

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