Hematological predictors of mortality in neonates with fulminant necrotizing enterocolitis

• Type of Material: Article
• Authors: Parvesh M Garg, University of Mississippi; Anna O'Connor, University of Mississippi; Md Abu Yusuf Ansari, University of Mississippi; Binh Vu, University of Mississippi; Haley Hobart, University of Mississippi; Jaslyn L Paschal, University of Mississippi; Harleen Multani, University of Mississippi; Cassandra Josephson, Emory University; Victoria Okhomina, University of Mississippi
• Language: English
• Date: 2021-03-26
• Publisher: SPRINGERNATURE
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s), under exclusive licence to Springer Nature America, Inc. 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41372-021-01044-3
• Title of Journal or Parent Work: JOURNAL OF PERINATOLOGY
• Volume: 41
• Issue: 5
• Start Page: 1110
• End Page: 1121
• Keywords: Life Sciences & Biomedicine; Obstetrics & Gynecology; Pediatrics; Science & Technology
• Research Categories: Health Sciences, Pathology

Abstract

Objective: Determine whether hematological and transfusion patterns following, the onset of NEC can identify infants likely to develop fulminant, fatal necrotizing enterocolitis (NEC). Design: Determine hematological predictors of fulminant NEC. Results: Of 336 neonates with NEC, 35 (10%) who developed fulminant NEC were born with higher birth weights and more frequently developed radiologically evident pneumoperitoneumand/or portal venous gas. Following the diagnosis of NEC, these infants were more likely to rapidly develop thrombocytopenia, lymphopenia, neutropenia, and lower total white blood cell counts compared to medical/surgical non-fulminant type. They were also more likely to have received a red blood cell (RBC) transfusion (76.7% vs. 53.1%, p = 0.001) within 48 h after disease onset and platelet transfusion (24.2% vs. 11.7%; p = 0.03) before the onset of NEC. Conclusion: Neonates with fulminant NEC frequently developed thrombocytopenia, lymphopenia, neutropenia, and leukopenia, received RBC transfusions after or platelet transfusions before the onset of NEC developed the fulminant disease.