Current Pediatric Research

Background: Necrotizing Enterocolitis (NEC) has high neonatal morbidity and mortality, early prediction plays a role in prognosis; due to vague early symptoms and lack of specific biomarker. Objective: Value of urinary Intestinal Fatty acid Binding Protein for early diagnosis and prediction of NEC in correlation with GutCheckNEC score. Patients and Methods: A case control study included fifty preterm neonates over a period of one year, classified into two groups: 25 neonates with feeding intolerance prior NEC diagnosis with a gestational age 27-33 weeks regardless of birth weight matched with 25 healthy preterms, excluding neonates with previous abdominal surgery, congenital anomaly of the gastrointestinal tract or abdominal wall including gastroscisis, patients with known or suspected inflammatory disease, patients with acute kidney injury or parental refusal of enrollment. Results: GutCheckNEC score initially and after 14 days was significantly higher in cases compared to controls with P<0.01, blood transfusion, metabolic acidosis, out born status and low gestational age were associated with higher score initially (P<0.01,0.04,0.01 and 0.005 respectively), after 14 days blood transfusion, culture proved sepsis and metabolic acidosis had significantly higher score (P<0.04, 0.05 and 0.01),u-IFABP level tended to be higher in cases (P<0.001), Receiver operating characteristic curve (ROC curve) of NEC diagnosis using u-IFABP level showed cut-off >14 ng/mL with 96% sensitivity and 100% specificity. Conclusion: Both GutCheckNEC and u-IFABP have a good prognostic value in early diagnosis of NEC, however no correlation was found between score items and u-IFABP level.

Author(s): Ibrahim Saad Hassan Abu Saif, Walaa Ahmed Yousry Kabiel, Aya Abdelaziz Abdelkarim, Wafaa Osman Ahmed*

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