NEC incidence and severity, sepsis incidence, and baseline data in the pre-probiotics vs routine probiotics epochs
Factor | Pre-probiotics epoch n=469 | Routine probiotics epoch n=513 |
NEC diagnostic system | ||
Modified Bell’s ≥2a | 35 (7.5%) | 16 (3.1%) |
Vermont-Oxford | 30 (6.4%) | 15 (2.9%) |
Battersby et al | 37 (7.9%) | 19 (3.7%) |
NEC severity | ||
Modified Bell’s 2a or 2b | 6 (1.3%) | 2 (0.4%) |
Modified Bell’s 3a or 3b | 29 (6.2%) | 14 (2.7%) |
Surgical NEC | 30 (6.4%) | 15 (2.9%) |
Drains only | 4 | 1 |
Laparotomy±drain | 20 | 13 |
Died before laparotomy | 6 | 1 |
Postnatal age at NEC diagnosis (days) | 12 (6–21) | 18 (11–30) |
Postmenstrual age at NEC diagnosis (weeks) | 27 (26–29) | 28 (26–31) |
Mortality before discharge among NEC cases | 16 (46%) | 3 (19%) |
Spontaneous intestinal perforation | 2 (0.4%) | 6 (1.1%) |
Sepsis | ||
Early onset sepsis | 10 (1.1%) | 1 (0.2%) |
Late-onset sepsis | 106 (22.6%) | 59 (11.5%) |
Responsible isolates* | ||
CoNS | 87 (18.6%) | 47 (9.2%) |
Gram-negative | 19 (4.1%) | 6 (1.2%) |
Enterococcus | 11 (2.3%) | 2 (0.4%) |
Other organism | 15 (3.2%) | 6 (1.2%) |
Lactobacillus or Bifidobacterium sepsis | 0 (0%) | 0 (0%) |
Sex, female | 225 (48%) | 261 (51%) |
Mode of delivery | ||
Vaginal | 193 (42%) | 229 (45%) |
Caesarean | 271 (58%) | 284 (55%) |
PROM | ||
No | 306 (65%) | 347 (68%) |
Yes | 103 (22%) | 118 (23%) |
Not recorded | 60 (13%) | 48 (9%) |
NSAID treatment for PDA | ||
None | 421 (90%) | 487 (95%) |
Indometacin | 37 (8%) | 0 (0%) |
Ibuprofen | 11 (2%) | 26 (5%) |
Birth weight (g) | 1100 (810–1410) | 1100 (832–1430) |
Gestational age (weeks) | 28 (26–30) | 28 (26–31) |
SGA | 114 (24%) | 132 (26%) |
Antenatal steroids | 405 (87%) | 447 (88%) |
Received initial antibiotics† | 502/599 (83.8%) | 509/597 (85.6%) |
Days to first enteral feed | 2 (1–4) | 2 (2–3) |
Enteral feeding‡ | ||
Never fed | 34 (7%) | 32 (6%) |
Mother’s own breast milk only | 198 (42%) | 322 (63%) |
Donor breast milk only | 0 (0%) | 9 (2%) |
Preterm formula only | 50 (11%) | 23 (4%) |
Mixed (formula and any breast milk) | 186 (40%) | 127 (25%) |
Data are median (IQR) or number (%).
*For individual infants who had at least one such sepsis episode.
†Data presented are for all babies born at <32 weeks’ gestation within the epochs who received initial empirical antibiotics (benzylpenicillin and gentamicin) following admission to NICU.
‡Mode of milk feeding between first feed and full feeds or NEC/death if earlier.
PDA, patent ductus arteriosus; CoNS, coagulase-negative staphylococci;NEC, necrotising enterocolitis; NICU, neonatal intensive care unit; NSAID, non-steroidal anti-inflammatory drug; PROM, prolonged rupture of membranes;SGA, small for gestational age.