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Blood absolute monocyte count trends in preterm infants with suspected necrotizing enterocolitis: an adjunct tool for diagnosis?

Journal of Perinatology (2024)Cite this article

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Abstract

Objective

We investigated the trends of blood absolute monocyte count (AMC) over 72 h after suspecting necrotizing enterocolitis (NEC).

Study design

A single center, retrospective study, the AMC was plotted over 72 h after NEC evaluation. Receiver operating characteristic (ROC) curve analysis assessed change in AMC to identify absence of NEC and different NEC stages.

Results

In 130 infants, the AMC decreased in patients with NEC stage 2 or 3. Stages 2 and 3 NEC experienced a drop in AMC compared to an increase in no NEC, possible NEC, or positive culture (p < 0.05). AMC increase 24% or less can differentiate NEC stage 2/3 from possible NEC with an area under the curve (AUC) of 0.78. While decrease of more than 32% can differentiate stage 2/3 vs. possible or no NEC with AUC of 0.71.

Discussion/Conclusions

A decrease in AMC can be an adjunct biomarker to confirm the diagnosis of NEC.

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Fig. 1: Evaluation of average AMC across time.
Fig. 2: Change in AMC from baseline to illness onset.
Fig. 3: ROC curve analyses to assess validity of percentage change in AMC from baseline to NEC suspicion.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Division of Neonatology, CHOC Children’s, Orange, CA, USA

    Meghan Moroze, Grant Shafer & Michel Mikhael

  2. CHOC Children’s Research Institute, Orange, CA, USA

    Tricia Morphew & Lois W. Sayrs

  3. Division of Radiology, CHOC Children’s, Orange, CA, USA

    Azam Eghbal & W. Nathan Holmes

  4. University of California Irvine, School of Medicine, Irvine, CA, USA

    Grant Shafer & Michel Mikhael

Authors
  1. Meghan Moroze
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  4. Azam Eghbal
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  5. W. Nathan Holmes
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  6. Grant Shafer
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  7. Michel Mikhael
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Contributions

Drs. Moroze, Shafer, and Mikhael contributed to the conceptualization and design of the study, the collection, analysis, and interpretation of the data. They drafted the initial manuscript and approved the final manuscript as submitted. Mrs. Morphew and Dr. Sayrs contributed to the analysis and interpretation of the data. They contributed to all drafts of the manuscript and approved the final manuscript as submitted. Drs. Eghbal and Holmes contributed to the collection, analysis, and interpretation of the data. They contributed to all drafts of the manuscript and approved the final manuscript as submitted.

Corresponding author

Correspondence to Michel Mikhael.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study protocol was reviewed and approved by Children’s Hospital of Orange County IRB Committee, IRB ID 1919772-1 internal number 200574. No ethics approval was needed. This study was granted by the Children’s Hospital of Orange County IRB, an exemption from written informed consent given the retrospective nature of the study.

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Moroze, M., Morphew, T., Sayrs, L.W. et al. Blood absolute monocyte count trends in preterm infants with suspected necrotizing enterocolitis: an adjunct tool for diagnosis?. J Perinatol (2024). https://doi.org/10.1038/s41372-024-02070-7

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  • DOI: https://doi.org/10.1038/s41372-024-02070-7

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