Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study

Melanie Kapapa; Janina Hahne; Alexandre Serra

doi:doi:10.11648/j.ajp.20220804.20

| Peer-Reviewed

Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study

Melanie Kapapa, Janina Hahne, Alexandre Serra

Published in American Journal of Pediatrics (Volume 8, Issue 4)

Received: 27 September 2022 Accepted: 25 October 2022 Published: 23 November 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Survival in preterm infants is strongly related to the occurrence of necrotizing enterocolitis (NEC) with intestinal perforation (NECp) compared to preterm with a focal intestinal perforation (FIP). Objective: The aim of this study was to elicit potential parental risk factors through a detailed maternal medical history and a comprehensive family history. Methods: A case-control design was used to compare both maternal medical history, factors such as drug use, individual lifestyle habits and external risk factors using standardized antenatal based questionnaires. The survey is completed by an interview with the participating parents of NEC, NECp, FIP and the control group (CG). Approval was granted by the local ethics committee (no. 13/15). Results: NEC/NECp mothers took more contraceptives (p=0.001), paracetamol (p=0.004), iodide (p=0.05) and calcium (p=0.04) and suffered from placental abruption (p=0.047), while fathers smoked more cigarettes/d (p=0.049). FIP mothers suffered from prolapsing amniotic sac (p=0.028) and alcohol consumption (p=0.034). NECp/ FIP mothers took more antibiotics (p<0.001). NEC/ FIP mothers were more likely to have uterine isthmus insufficiency (p=0.042). Conclusion: The accumulation of external factors such as alcohol consumption and passive nicotine use, the use of antibiotics and oral contraceptives together with pregnancy-associated maternal factors such as placental abruption and uterine isthmus insufficiency leads to higher rates of intestinal perforation in preterm infants.

Published in	American Journal of Pediatrics (Volume 8, Issue 4)
DOI	10.11648/j.ajp.20220804.20
Page(s)	252-257
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Risk Factor, Necrotizing Enterocolitis, Focal Intestinal Perforation, Preterm, Bowel Perforation

References

[1]	Wadhawan R, Oh W, Vohr BR, Saha S, Das A, Bell EF, et al. Spontaneous intestinal perforation in extremely low birth weight infants: association with indometacin therapy and effects on neurodevelopmental outcomes at 18-22 months corrected age. Archives of disease in childhood Fetal and neonatal edition. 2013; 98 (2): F127-32.
[2]	Mannan MA, Jahan N, Dey SK, Uddin MF, Ahmed S. Maternal and foetal risk factor and complication with immediate outcome during hospital stay of very low birth weight babies. Mymensingh medical journal: MMJ. 2012; 21 (4): 639-47.
[3]	Rastogi S, Rojas M, Rastogi D, Haberman S. Neonatal morbidities among full-term infants born to obese mothers. The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2015; 28 (7): 829-35.
[4]	Lu Q, Cheng S, Zhou M, Yu J. Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study. Pediatrics and neonatology. 2017; 58 (2): 165-70.
[5]	Lee JY, Park KH, Kim A, Yang HR, Jung EY, Cho SH. Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants. Pediatrics and neonatology. 2017; 58 (1): 57-62.
[6]	March MI, Gupta M, Modest AM, Wu L, Hacker MR, Martin CR, et al. Maternal risk factors for neonatal necrotizing enterocolitis. The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2015; 28 (11): 1285-90.
[7]	Ding G, Yu J, Chen Y, Vinturache A, Pang Y, Zhang J. Maternal Smoking during Pregnancy and Necrotizing Enterocolitis-associated Infant Mortality in Preterm Babies. Scientific reports. 2017; 7: 45784.
[8]	Gephart SM, McGrath JM, Effken JA, Halpern MD. Necrotizing enterocolitis risk: state of the science. Advances in neonatal care: official journal of the National Association of Neonatal Nurses. 2012; 12 (2): 77-87; quiz 8-9.
[9]	Alshaarawy O, Breslau N, Anthony JC. Monthly Estimates of Alcohol Drinking During Pregnancy: United States, 2002-2011. Journal of studies on alcohol and drugs. 2016; 77 (2): 272-6.
[10]	Yang CC, Tang PL, Liu PY, Huang WC, Chen YY, Wang HP, et al. Maternal pregnancy-induced hypertension increases subsequent neonatal necrotizing enterocolitis risk: A nationwide population-based retrospective cohort study in Taiwan. Medicine. 2018 97 (31): e11739.
[11]	Wadhawan R, Oh W, Hintz SR, Blakely ML, Das A, Bell EF, et al. Neurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis. Journal of perinatology: official journal of the California Perinatal Association. 2014; 34 (1): 64-70.
[12]	Markel TA, Engelstad H, Poindexter BB. Predicting disease severity of necrotizing enterocolitis: how to identify infants for future novel therapies. Journal of clinical neonatology. 2014; 3 (1): 1-9.
[13]	Ragouilliaux CJ, Keeney SE, Hawkins HK, Rowen JL. Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation. Pediatrics. 2007; 120 (6): e1458-64.
[14]	Jensen ET, Daniels JL, Sturmer T, Robinson WR, Williams CJ, Vejrup K, et al. Hormonal contraceptive use before and after conception in relation to preterm birth and small for gestational age: an observational cohort study. BJOG: an international journal of obstetrics and gynaecology. 2015; 122 (10): 1349-61.
[15]	Romejko-Wolniewicz E, Teliga-Czajkowska J, Czajkowski K. Antenatal steroids: can we optimize the dose? Current opinion in obstetrics & gynecology. 2014; 26 (2): 77-82.
[16]	Cetinkaya M, Erener-Ercan T, Kalayci-Oral T, Babayigit A, Cebeci B, Semerci SY, et al. Maternal/neonatal vitamin D deficiency: a new risk factor for necrotizing enterocolitis in preterm infants? Journal of perinatology: official journal of the California Perinatal Association. 2017; 37 (6): 673-8.
[17]	Mazzocchi A, Leone L, Agostoni C, Pali-Scholl I. The Secrets of the Mediterranean Diet. Does [Only] Olive Oil Matter? Nutrients. 2019; 11 (12).
[18]	Ahle M, Drott P, Elfvin A, Andersson RE. Maternal, fetal and perinatal factors associated with necrotizing enterocolitis in Sweden. A national case-control study. PloS one. 2018; 13 (3): e0194352.
[19]	Duci M, Frigo AC, Visentin S, Verlato G, Gamba P, Fascetti-Leon F. Maternal and placental risk factors associated with the development of necrotizing enterocolitis (NEC) and its severity. Journal of pediatric surgery. 2019.
[20]	Tiwari C, Sandlas G, Jayaswal S, Shah H. Spontaneous intestinal perforation in neonates. Journal of neonatal surgery. 2015; 4 (2): 14.
[21]	Kapapa M, Rieg T, Henne-Bruns D, Serra A. Risk factors for abdominal wall defects. Congenital Anomalies; 2020, 60, 43-78.
[22]	Berglund A, Johannsen TH, Stochholm K, Aksglaede L, Fedder J, Viuff MH, et al. Incidence, prevalence, diagnostic delay, morbidity, mortality and socioeconomic status in males with 46, XX disorders of sex development: a nationwide study. Human reproduction (Oxford, England). 2017; 32 (8): 1751-60.

Cite This Article

Plain Text BibTeX RIS

APA Style

Melanie Kapapa, Janina Hahne, Alexandre Serra. (2022). Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study. American Journal of Pediatrics, 8(4), 252-257. https://doi.org/10.11648/j.ajp.20220804.20

Copy | Download

ACS Style

Melanie Kapapa; Janina Hahne; Alexandre Serra. Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study. Am. J. Pediatr. 2022, 8(4), 252-257. doi: 10.11648/j.ajp.20220804.20

Copy | Download

AMA Style

Melanie Kapapa, Janina Hahne, Alexandre Serra. Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study. Am J Pediatr. 2022;8(4):252-257. doi: 10.11648/j.ajp.20220804.20

Copy | Download

@article{10.11648/j.ajp.20220804.20,
  author = {Melanie Kapapa and Janina Hahne and Alexandre Serra},
  title = {Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study},
  journal = {American Journal of Pediatrics},
  volume = {8},
  number = {4},
  pages = {252-257},
  doi = {10.11648/j.ajp.20220804.20},
  url = {https://doi.org/10.11648/j.ajp.20220804.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220804.20},
  abstract = {Background: Survival in preterm infants is strongly related to the occurrence of necrotizing enterocolitis (NEC) with intestinal perforation (NECp) compared to preterm with a focal intestinal perforation (FIP). Objective: The aim of this study was to elicit potential parental risk factors through a detailed maternal medical history and a comprehensive family history. Methods: A case-control design was used to compare both maternal medical history, factors such as drug use, individual lifestyle habits and external risk factors using standardized antenatal based questionnaires. The survey is completed by an interview with the participating parents of NEC, NECp, FIP and the control group (CG). Approval was granted by the local ethics committee (no. 13/15). Results: NEC/NECp mothers took more contraceptives (p=0.001), paracetamol (p=0.004), iodide (p=0.05) and calcium (p=0.04) and suffered from placental abruption (p=0.047), while fathers smoked more cigarettes/d (p=0.049). FIP mothers suffered from prolapsing amniotic sac (p=0.028) and alcohol consumption (p=0.034). NECp/ FIP mothers took more antibiotics (p<0.001). NEC/ FIP mothers were more likely to have uterine isthmus insufficiency (p=0.042). Conclusion: The accumulation of external factors such as alcohol consumption and passive nicotine use, the use of antibiotics and oral contraceptives together with pregnancy-associated maternal factors such as placental abruption and uterine isthmus insufficiency leads to higher rates of intestinal perforation in preterm infants.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study
AU  - Melanie Kapapa
AU  - Janina Hahne
AU  - Alexandre Serra
Y1  - 2022/11/23
PY  - 2022
N1  - https://doi.org/10.11648/j.ajp.20220804.20
DO  - 10.11648/j.ajp.20220804.20
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 252
EP  - 257
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20220804.20
AB  - Background: Survival in preterm infants is strongly related to the occurrence of necrotizing enterocolitis (NEC) with intestinal perforation (NECp) compared to preterm with a focal intestinal perforation (FIP). Objective: The aim of this study was to elicit potential parental risk factors through a detailed maternal medical history and a comprehensive family history. Methods: A case-control design was used to compare both maternal medical history, factors such as drug use, individual lifestyle habits and external risk factors using standardized antenatal based questionnaires. The survey is completed by an interview with the participating parents of NEC, NECp, FIP and the control group (CG). Approval was granted by the local ethics committee (no. 13/15). Results: NEC/NECp mothers took more contraceptives (p=0.001), paracetamol (p=0.004), iodide (p=0.05) and calcium (p=0.04) and suffered from placental abruption (p=0.047), while fathers smoked more cigarettes/d (p=0.049). FIP mothers suffered from prolapsing amniotic sac (p=0.028) and alcohol consumption (p=0.034). NECp/ FIP mothers took more antibiotics (p<0.001). NEC/ FIP mothers were more likely to have uterine isthmus insufficiency (p=0.042). Conclusion: The accumulation of external factors such as alcohol consumption and passive nicotine use, the use of antibiotics and oral contraceptives together with pregnancy-associated maternal factors such as placental abruption and uterine isthmus insufficiency leads to higher rates of intestinal perforation in preterm infants.
VL  - 8
IS  - 4
ER  -

Copy | Download

Author Information

Melanie Kapapa

Department of Surgery, Division of Pediatric Surgery, University Hospital, Ulm, Germany
Janina Hahne

Department of Paediatric and Adolescent Medicine, University Hospital, Ulm, Germany
Alexandre Serra

Department of Surgery, Division of Pediatric Surgery, University Hospital, Ulm, Germany

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Melanie Kapapa, Janina Hahne, Alexandre Serra. (2022). Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study. American Journal of Pediatrics, 8(4), 252-257. https://doi.org/10.11648/j.ajp.20220804.20

Copy | Download

ACS Style

Melanie Kapapa; Janina Hahne; Alexandre Serra. Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study. Am. J. Pediatr. 2022, 8(4), 252-257. doi: 10.11648/j.ajp.20220804.20

Copy | Download

AMA Style

Melanie Kapapa, Janina Hahne, Alexandre Serra. Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study. Am J Pediatr. 2022;8(4):252-257. doi: 10.11648/j.ajp.20220804.20

Copy | Download

@article{10.11648/j.ajp.20220804.20,
  author = {Melanie Kapapa and Janina Hahne and Alexandre Serra},
  title = {Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study},
  journal = {American Journal of Pediatrics},
  volume = {8},
  number = {4},
  pages = {252-257},
  doi = {10.11648/j.ajp.20220804.20},
  url = {https://doi.org/10.11648/j.ajp.20220804.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220804.20},
  abstract = {Background: Survival in preterm infants is strongly related to the occurrence of necrotizing enterocolitis (NEC) with intestinal perforation (NECp) compared to preterm with a focal intestinal perforation (FIP). Objective: The aim of this study was to elicit potential parental risk factors through a detailed maternal medical history and a comprehensive family history. Methods: A case-control design was used to compare both maternal medical history, factors such as drug use, individual lifestyle habits and external risk factors using standardized antenatal based questionnaires. The survey is completed by an interview with the participating parents of NEC, NECp, FIP and the control group (CG). Approval was granted by the local ethics committee (no. 13/15). Results: NEC/NECp mothers took more contraceptives (p=0.001), paracetamol (p=0.004), iodide (p=0.05) and calcium (p=0.04) and suffered from placental abruption (p=0.047), while fathers smoked more cigarettes/d (p=0.049). FIP mothers suffered from prolapsing amniotic sac (p=0.028) and alcohol consumption (p=0.034). NECp/ FIP mothers took more antibiotics (p<0.001). NEC/ FIP mothers were more likely to have uterine isthmus insufficiency (p=0.042). Conclusion: The accumulation of external factors such as alcohol consumption and passive nicotine use, the use of antibiotics and oral contraceptives together with pregnancy-associated maternal factors such as placental abruption and uterine isthmus insufficiency leads to higher rates of intestinal perforation in preterm infants.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Prematurity Combined with Parental Risk Factors Increase the Number of Intestinal Perforations: A Case Control Study
AU  - Melanie Kapapa
AU  - Janina Hahne
AU  - Alexandre Serra
Y1  - 2022/11/23
PY  - 2022
N1  - https://doi.org/10.11648/j.ajp.20220804.20
DO  - 10.11648/j.ajp.20220804.20
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 252
EP  - 257
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20220804.20
AB  - Background: Survival in preterm infants is strongly related to the occurrence of necrotizing enterocolitis (NEC) with intestinal perforation (NECp) compared to preterm with a focal intestinal perforation (FIP). Objective: The aim of this study was to elicit potential parental risk factors through a detailed maternal medical history and a comprehensive family history. Methods: A case-control design was used to compare both maternal medical history, factors such as drug use, individual lifestyle habits and external risk factors using standardized antenatal based questionnaires. The survey is completed by an interview with the participating parents of NEC, NECp, FIP and the control group (CG). Approval was granted by the local ethics committee (no. 13/15). Results: NEC/NECp mothers took more contraceptives (p=0.001), paracetamol (p=0.004), iodide (p=0.05) and calcium (p=0.04) and suffered from placental abruption (p=0.047), while fathers smoked more cigarettes/d (p=0.049). FIP mothers suffered from prolapsing amniotic sac (p=0.028) and alcohol consumption (p=0.034). NECp/ FIP mothers took more antibiotics (p<0.001). NEC/ FIP mothers were more likely to have uterine isthmus insufficiency (p=0.042). Conclusion: The accumulation of external factors such as alcohol consumption and passive nicotine use, the use of antibiotics and oral contraceptives together with pregnancy-associated maternal factors such as placental abruption and uterine isthmus insufficiency leads to higher rates of intestinal perforation in preterm infants.
VL  - 8
IS  - 4
ER  -

Copy | Download