Diagnostic and prognostic values of abdominal ultrasound combined with urinary intestinal fatty acid binding protein for neonatal necrotizing enterocolitis

Diagnosis of neonatal necrotizing enterocolitis

Abstract

Necrotizing enterocolitis (NEC) triggers extensive or localized necrosis of the small intestine and colon in neonates. Here, we studied the diagnostic and prognostic values of abdominal ultrasound combined with urinary intestinal fatty acid binding protein (I-FABP) for NEC. Ninety-eight NEC neonates were divided into a suspected NEC group (n=57) and a confirmed NEC group (n=41). They were further divided into an internal medicine treatment group (n=54) and an operation group (n=44) according to disease progression. The influencing factors were explored by multivariate analysis. The diagnostic values of abdominal ultrasound and I-FABP alone or in combination were analyzed by receiver operating characteristic (ROC) curves. Further, 1-year survival rates were analyzed by Kaplan-Meier survival curves. Premature birth, meconium-stained amniotic fluid, neonatal septicemia, maternal gestational diabetes mellitus, non-exclusive breastfeeding, non-prophylactic application of probiotics and I-FABP >6.25 ng/mL were risk factors for NEC (P <0.05). The confirmed NEC group had higher proportions of neonates with intestinal wall thickening, portal venous gas, disappearance of intestinal peristalsis, peritoneal effusion and decreased intestinal wall blood perfusion than the suspected NEC group (P