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Potential confounder of NEC clinical trials

Journal of Perinatology volume 29, pages 256–257 (2009)Cite this article

We would like to congratulate Moss et al.1 for their recent multi-center cohort study looking for clinical parameters that predict the outcome in necrotizing enterocolitis (NEC). Enrolling over 450 patients with NEC is a feat. However, we write to offer a different interpretation of their findings, particularly the association of NEC with progression to severe disease (i.e. surgery) within infants having never received enteral feeds.

Moss et al. discuss gut priming in depth as a possible preventive strategy in their manuscript, but they make no mention of another disease process that is found in up to 8% of our smallest premature infants,2 specifically, spontaneous (or focal) intestinal perforation (SIP), which typically occurs in infants who have not been enterally fed in the first weeks of life.3, 4

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References

  1. Moss RL, Kalish LA, Duggan C, Johnston P, Brandt M, Dunn JCY et al. Clinical parameters do not adequately predict outcome in necrotizing enterocolitis: a multi-institutional study. J Perinatol 2008; 28: 665–674.

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Authors and Affiliations

  1. MidAtlantic Neonatology Associates, Morristown Memorial Hospital, Morristown, NJ, USA

    J R Swanson

  2. University of Virginia Children's Hospital, Charlottesville, VA, USA

    J T Attridge

  3. Ochsner Health System, New Orleans, LA, USA

    P V Gordon

Authors
  1. J R Swanson
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  2. J T Attridge
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  3. P V Gordon
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Correspondence to J R Swanson.

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Swanson, J., Attridge, J. & Gordon, P. Potential confounder of NEC clinical trials. J Perinatol 29, 256–257 (2009). https://doi.org/10.1038/jp.2008.242

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