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. 2025 May 27;17(5):e84906.
doi: 10.7759/cureus.84906. eCollection 2025 May.

Association Between a Decrease in Blood Monocyte Counts and Necrotizing Enterocolitis in Preterm Infants

Supriya Bisht  1 , Kim Roger  2 , Sharef Al-Mulaabed  3 , Fernanda E Kupferman  2
Affiliations

Association Between a Decrease in Blood Monocyte Counts and Necrotizing Enterocolitis in Preterm Infants

Supriya Bisht et al. Cureus. .

Abstract

Objective: To explore the association between absolute monocyte count (AMC) and necrotizing enterocolitis (NEC) in preterm neonates and to assess whether a fall in AMC can be used as a biomarker to predict an increased risk for NEC.

Study design: This was a retrospective study of preterm neonates with NEC or a first episode of feeding intolerance (FI). Their complete blood count (CBC) was evaluated for AMC at three time points, first at baseline, second at the onset of NEC/FI, and third afterwards. Statistical analysis was done using Student's t-test and the chi-squared test. The p-value of <0.05 was considered significant.

Results: Of the total 92 newborns, 29 (31.5%) had NEC, while 63 (68.5%) had FI. NEC and FI groups were comparable in gestational age (GA) and birth weight. There was a significant increase in AMC in the FI group (p<0.001) from baseline to the onset of FI. However, the AMC had a fall in the NEC group from baseline to the onset of NEC, which was not statistically significant (p=0.074).

Conclusion: A decrease in AMC was associated with the presence of NEC. A fall in the AMC could be a biomarker to identify an increased risk of NEC in preterm neonates with feeding problems.

Keywords: absolute monocyte count; feeding intolerance; necrotizing enterocolitis; neonate; preterm.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow diagram of the subjects in the study.
GA = Gestational age; NEC = Necrotizing enterocolitis
Figure 2
Figure 2. The changes of absolute monocyte count (AMC) at three time points in FI and NEC groups
(A) Feeding intolerance (FI) group. (B) Necrotizing enterocolitis (NEC) group
See this image and copyright information in PMC

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