Association of Placental Pathology and antibiotic exposure after birth with the Severity of Necrotizing Enterocolitis in Preterm infants - A Matched Case-Control Study

TL;DR

This study found that preterm infants who received antibiotics for more than three days after birth were at higher risk of severe NEC and death.

Contribution

The study identifies a novel association between prolonged early antibiotic exposure and increased severity of NEC in preterm infants.

Findings

Infants on antibiotics >3 days had higher risk for medical and surgical NEC.

Prolonged antibiotic use was linked to a significantly higher risk of death in NEC cases.

Abstract

To determine the association between antibiotic exposure following birth and necrotizing enterocolitis (NEC) severity in preterm infants.

This single center matched case-control study included infants with NEC (n=107) and matched controls (n= 130) with antibiotic exposure =< 3 days and > 3 days after birth.

Out of 212 infants,103 infants (48.5%) received antibiotics =< 3 days, and 109 infants (51.5%) received antibiotics >3 days. On the multivariate regression, Infants receiving antibiotics for >3 day had higher risk for medical NEC (aOR 2.61,95% CI 1.35 −5.16; p=0.005) and surgical NEC (aOR 3.33, CI 1.57–7.40; p=0.02) than controls. In NEC cohort, those receiving antibiotics for >3 days were like to die (OR 7.88,95% CI 1.99- 53.74; p=0.010) than those receiving antibiotics <3 days.

Infants exposed with early antibiotics >3 days after birth were more likely associated with NEC and were at greater risk of death.