Risk factors for spontaneous localized intestinal perforation in the preterm infant

Abstract

Purpose: The aim of this study was to investigate prenatal and postnatal risk factors for spontaneous intestinal perforation (SIP) in preterm infants.

Material and methods: Matched case-control study of 62 preterm infants (matching based on gender, gestational age and birth weight) who developed a SIP over a period of 20 years in a single NICU. Univariate and multivariate logistic regression analysis were performed.

Results: Prenatal risk factors were not significantly different between cases and controls. Patients exposed to surfactant and inotropic agents have an increased risk for SIP. No initiation of feeding before development of SIP and IVH ≥ grade 3 were also associated with an increased risk for SIP. In multivariate analysis inotropic agents, lack of initiation of feeding and IVH ≥ grade 3 remained significant risk factors (OR 5.58 (95% CI 1.14–27.22), 0.29 (95% CI 0.09–0.88), 15.2 (95% CI 1.09–211.55) respectively).

Conclusions: The study found that patients with SIP are more likely to have been exposed to inotropic agents and to have developed IVH ≥ grade 3. They were also less likely to have been fed. These risk factors most likely reflect the severity of illness of preterm infants and an increased vulnerability for developing SIP.

Keywords:

• Preterm
• spontaneous intestinal perforation
• risk factor
• NSAID
• corticosteroids
• inotropic agents

Acknowledgements

Statistical analysis: Steffen Fieuws, Raf Aerts

Data acquisition: Suzanna Barten, Hugo Devlieger

Editing of text: Michael Whittakker.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

Maissa Rayyan is supported by KOOR, a Clinical Research Fund from University Hospitals Leuven to promote clinical scientific research. Karel Allegaert has been supported by the Fund for Scientific Research, Flanders, Belgium (F.W.O. Vlaanderen) by a Fundamental Clinical Investigatorship. His research activities are further facilitated by the Agency for Innovation by Science and Technology in Flanders (IWT) through the SAFEPEDRUG project (IWT/SBO 130 033).