Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation

Corinne J. Ragouilliaux, Susan E. Keeney, Hal K. Hawkins, Judith L. Rowen

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

BACKGROUND. Spontaneous intestinal perforation of the extremely low birth weight infant (≤1000 g) is associated with a high incidence of Candida and coagulase-negative Staphylococcus sepsis. Little is known about prenatal risk factors, and histopathologic examination of placentas in infants with spontaneous intestinal perforation has not been reported. OBJECTIVES. Our objective was to investigate maternal factors and specific placental findings in a sample of infants with spontaneous intestinal perforation. We compared the maternal factors and clinical outcomes to a matched control group. PATIENTS AND METHODS. This single-center, retrospective cohort study was conducted between January 2001 and December 2005. The records of extremely low birth weight infants with spontaneous intestinal perforation were reviewed (n = 16). Study infants were matched to 2 infants in the control group; any twin of a study patient was also included as a control subject (n = 35). Histopathologic examination of placentas included standard hematoxylin and eosin and methenamine silver stains. RESULTS. Infants with spontaneous intestinal perforation were more likely than control subjects to have severe placental chorioamnionitis with fetal vascular response (40% vs 12%); 2 placentas also tested positive for yeast versus none in the control subjects. Mothers of infants with spontaneous intestinal perforation were more likely than control subjects to have received antibiotics before or at delivery (93% vs 57%). Fifty percent of the infants had Candida, and 31% in the spontaneous intestinal perforation group had coagulase-negative Staphylococcus sepsis versus 6% in the control subjects. Finally, infants with spontaneous intestinal perforation had delayed enteral feeding (64 ± 30 vs 31 ± 10 days) and prolonged hospitalization (155 ± 48 vs 108 ± 36 days). CONCLUSIONS. Spontaneous intestinal perforation in the extremely low birth weight infant is a neonatal disease related to placental inflammation. We alert practitioners to the importance of placental findings, because they may be positive for yeast.

Original languageEnglish (US)
JournalPediatrics
Volume120
Issue number6
DOIs
StatePublished - Dec 2007

Fingerprint

Extremely Low Birth Weight Infant
Intestinal Perforation
Mothers
Placenta
Coagulase
Staphylococcus
Candida
Infant, Newborn, Diseases
Sepsis
Yeasts
Methenamine
Chorioamnionitis
Spontaneous Perforation
Control Groups
Twin Studies
Enteral Nutrition
Hematoxylin
Eosine Yellowish-(YS)
Blood Vessels
Hospitalization

Keywords

  • Candidiasis
  • Chorioamnionitis
  • Coagulase-negative Staphylococcus
  • Funisitis
  • Neonate

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation. / Ragouilliaux, Corinne J.; Keeney, Susan E.; Hawkins, Hal K.; Rowen, Judith L.

In: Pediatrics, Vol. 120, No. 6, 12.2007.

Research output: Contribution to journalArticle

Ragouilliaux, Corinne J. ; Keeney, Susan E. ; Hawkins, Hal K. ; Rowen, Judith L. / Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation. In: Pediatrics. 2007 ; Vol. 120, No. 6.
@article{915ef491052c4fdba1dd0daba26271a1,
title = "Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation",
abstract = "BACKGROUND. Spontaneous intestinal perforation of the extremely low birth weight infant (≤1000 g) is associated with a high incidence of Candida and coagulase-negative Staphylococcus sepsis. Little is known about prenatal risk factors, and histopathologic examination of placentas in infants with spontaneous intestinal perforation has not been reported. OBJECTIVES. Our objective was to investigate maternal factors and specific placental findings in a sample of infants with spontaneous intestinal perforation. We compared the maternal factors and clinical outcomes to a matched control group. PATIENTS AND METHODS. This single-center, retrospective cohort study was conducted between January 2001 and December 2005. The records of extremely low birth weight infants with spontaneous intestinal perforation were reviewed (n = 16). Study infants were matched to 2 infants in the control group; any twin of a study patient was also included as a control subject (n = 35). Histopathologic examination of placentas included standard hematoxylin and eosin and methenamine silver stains. RESULTS. Infants with spontaneous intestinal perforation were more likely than control subjects to have severe placental chorioamnionitis with fetal vascular response (40{\%} vs 12{\%}); 2 placentas also tested positive for yeast versus none in the control subjects. Mothers of infants with spontaneous intestinal perforation were more likely than control subjects to have received antibiotics before or at delivery (93{\%} vs 57{\%}). Fifty percent of the infants had Candida, and 31{\%} in the spontaneous intestinal perforation group had coagulase-negative Staphylococcus sepsis versus 6{\%} in the control subjects. Finally, infants with spontaneous intestinal perforation had delayed enteral feeding (64 ± 30 vs 31 ± 10 days) and prolonged hospitalization (155 ± 48 vs 108 ± 36 days). CONCLUSIONS. Spontaneous intestinal perforation in the extremely low birth weight infant is a neonatal disease related to placental inflammation. We alert practitioners to the importance of placental findings, because they may be positive for yeast.",
keywords = "Candidiasis, Chorioamnionitis, Coagulase-negative Staphylococcus, Funisitis, Neonate",
author = "Ragouilliaux, {Corinne J.} and Keeney, {Susan E.} and Hawkins, {Hal K.} and Rowen, {Judith L.}",
year = "2007",
month = "12",
doi = "10.1542/peds.2006-2804",
language = "English (US)",
volume = "120",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "6",

}

TY - JOUR

T1 - Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation

AU - Ragouilliaux, Corinne J.

AU - Keeney, Susan E.

AU - Hawkins, Hal K.

AU - Rowen, Judith L.

PY - 2007/12

Y1 - 2007/12

N2 - BACKGROUND. Spontaneous intestinal perforation of the extremely low birth weight infant (≤1000 g) is associated with a high incidence of Candida and coagulase-negative Staphylococcus sepsis. Little is known about prenatal risk factors, and histopathologic examination of placentas in infants with spontaneous intestinal perforation has not been reported. OBJECTIVES. Our objective was to investigate maternal factors and specific placental findings in a sample of infants with spontaneous intestinal perforation. We compared the maternal factors and clinical outcomes to a matched control group. PATIENTS AND METHODS. This single-center, retrospective cohort study was conducted between January 2001 and December 2005. The records of extremely low birth weight infants with spontaneous intestinal perforation were reviewed (n = 16). Study infants were matched to 2 infants in the control group; any twin of a study patient was also included as a control subject (n = 35). Histopathologic examination of placentas included standard hematoxylin and eosin and methenamine silver stains. RESULTS. Infants with spontaneous intestinal perforation were more likely than control subjects to have severe placental chorioamnionitis with fetal vascular response (40% vs 12%); 2 placentas also tested positive for yeast versus none in the control subjects. Mothers of infants with spontaneous intestinal perforation were more likely than control subjects to have received antibiotics before or at delivery (93% vs 57%). Fifty percent of the infants had Candida, and 31% in the spontaneous intestinal perforation group had coagulase-negative Staphylococcus sepsis versus 6% in the control subjects. Finally, infants with spontaneous intestinal perforation had delayed enteral feeding (64 ± 30 vs 31 ± 10 days) and prolonged hospitalization (155 ± 48 vs 108 ± 36 days). CONCLUSIONS. Spontaneous intestinal perforation in the extremely low birth weight infant is a neonatal disease related to placental inflammation. We alert practitioners to the importance of placental findings, because they may be positive for yeast.

AB - BACKGROUND. Spontaneous intestinal perforation of the extremely low birth weight infant (≤1000 g) is associated with a high incidence of Candida and coagulase-negative Staphylococcus sepsis. Little is known about prenatal risk factors, and histopathologic examination of placentas in infants with spontaneous intestinal perforation has not been reported. OBJECTIVES. Our objective was to investigate maternal factors and specific placental findings in a sample of infants with spontaneous intestinal perforation. We compared the maternal factors and clinical outcomes to a matched control group. PATIENTS AND METHODS. This single-center, retrospective cohort study was conducted between January 2001 and December 2005. The records of extremely low birth weight infants with spontaneous intestinal perforation were reviewed (n = 16). Study infants were matched to 2 infants in the control group; any twin of a study patient was also included as a control subject (n = 35). Histopathologic examination of placentas included standard hematoxylin and eosin and methenamine silver stains. RESULTS. Infants with spontaneous intestinal perforation were more likely than control subjects to have severe placental chorioamnionitis with fetal vascular response (40% vs 12%); 2 placentas also tested positive for yeast versus none in the control subjects. Mothers of infants with spontaneous intestinal perforation were more likely than control subjects to have received antibiotics before or at delivery (93% vs 57%). Fifty percent of the infants had Candida, and 31% in the spontaneous intestinal perforation group had coagulase-negative Staphylococcus sepsis versus 6% in the control subjects. Finally, infants with spontaneous intestinal perforation had delayed enteral feeding (64 ± 30 vs 31 ± 10 days) and prolonged hospitalization (155 ± 48 vs 108 ± 36 days). CONCLUSIONS. Spontaneous intestinal perforation in the extremely low birth weight infant is a neonatal disease related to placental inflammation. We alert practitioners to the importance of placental findings, because they may be positive for yeast.

KW - Candidiasis

KW - Chorioamnionitis

KW - Coagulase-negative Staphylococcus

KW - Funisitis

KW - Neonate

UR - http://www.scopus.com/inward/record.url?scp=36849024430&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36849024430&partnerID=8YFLogxK

U2 - 10.1542/peds.2006-2804

DO - 10.1542/peds.2006-2804

M3 - Article

C2 - 17998314

AN - SCOPUS:36849024430

VL - 120

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 6

ER -