{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:13:22Z","timestamp":1793308402935,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["814168"],"award-info":[{"award-number":["814168"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Necrotizing enterocolitis (NEC) is associated with significant morbidity and mortality in preterm infants. Early recognition and treatment of NEC are critical to improving outcomes. Enteric nervous system (ENS) immaturity has been proposed as a key factor in NEC pathophysiology. Gastrointestinal dysmotility is associated with ENS immaturity and may serve as a predictive factor for the development of NEC. In this case\u2013control study, preterm infants (gestational age (GA)\u2009&lt;\u200930\u00a0weeks) were included in two level-IV neonatal intensive care units. Infants with NEC in the first month of life were 1:3 matched to controls based on GA (\u00b1\u20093\u00a0days). Odds ratios for NEC development were analyzed by logistic regression for time to first passage of meconium (TFPM), duration of meconial stool, and mean daily defecation frequency over the 72\u00a0h preceding clinical NEC onset (DF\u2009&lt;\u2009T0). A total of 39 NEC cases and 117 matched controls (median GA 27\u2009+\u20094\u00a0weeks) were included. Median TFPM was comparable in cases and controls (36\u00a0h [IQR 13\u201365] <jats:italic>vs.<\/jats:italic> 30\u00a0h [IQR 9\u201366], p\u2009=\u20090.83). In 21% of both cases and controls, TFPM was\u2009\u2265\u200972\u00a0h (p\u2009=\u20090.87). Duration of meconial stool and DF\u2009&lt;\u2009T0 were comparable in the NEC and control group (median 4 and 3, resp. in both groups). Odds of NEC were not significantly associated with TFPM, duration of meconial stools, and DF\u2009&lt;\u2009T0 (adjusted odds ratio [95% confidence interval]: 1.00 [0.99\u20131.03], 1.16 [0.86\u20131.55] and 0.97 [0.72\u20131.31], resp.).<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: In this cohort, no association was found between TFPM, duration of meconium stool, and DF\u2009&lt;\u2009T0 and the development of NEC.<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold><jats:italic>\u2022 Necrotizing enterocolitis (NEC) is a life-threatening acute intestinal inflammatory disease of the young preterm infant.\u00a0Early clinical risk factors for NEC have been investigated in order to facilitate early diagnosis and treatment.<\/jats:italic>\u2022\u00a0<jats:italic>Signs of disrupted gastrointestinal mobility, such as gastric retention and paralytic ileus, have been established\u00a0to support the diagnosis of NEC. Nevertheless, defecation patterns have insufficiently been studied in relation to the\u00a0disease.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold><jats:italic>\u2022 Defecation patterns in the three days preceding NEC did not differ from gestational age-matched controls of corresponding postnatal age. Additionally, the first passage of meconium and the duration of meconium\u00a0passage were comparable between cases and controls.\u00a0Currently, defecation patterns are not useful as early warning signs for NEC. It remains to be elucidated whether these parameters are different based on the location of intestinal necrosis.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-023-05035-8","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T15:33:05Z","timestamp":1687534385000},"page":"3907-3915","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Time to first passage of meconium and defecation frequency preceding necrotizing enterocolitis in preterm infants: a case\u2013control study"],"prefix":"10.1007","volume":"182","author":[{"given":"Nancy","family":"Deianova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quincy","family":"Moonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sientje E.","family":"Sluis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik J.","family":"Niemarkt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter J.","family":"de Jonge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Benninga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanne K. H.","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen L.","family":"Tanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam M.","family":"van Weissenbruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton H.","family":"van Kaam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim G. J.","family":"de Meij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan J. 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The study protocol was reviewed and approved by the local institutional review board of Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (approval number A2020.190).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from both parents and\/or legal guardians of all infants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"N.K.H. de Boer has served as a speaker for AbbVie and MSD and has served as consultant and\/or principal investigator for TEVA Pharma BV and Takeda; he has received a (unrestricted) research grant from Falk, TEVA Pharma BV, MLDS and Takeda. All outside the submitted work. I.J.N. Koppen has served as a speaker for Wellspect and as a consultant for Mahana Therapeutics. All outside the submitted work. M.A. Benninga has served as a speaker for Abbott, Menarini and United Pharmaceuticals and has served as consultant and\/or principal investigator for Coloplast, Wellspect, Norgine, Allergan, Mallinckrodt, Takeda, FrieslandCampina, Danone, HIPP, United Pharmaceuticals. All outside the submitted work. W.J. de Jonge holds unrestricted research grants: GlaxoSmithKline, Galvani Bioelectronics, Mead Johnson Nutrition, Reckitt Bengiser, Alimentiv BV, MRM health, Bristol Myers Squibb, Friesland Campina, Horaizon BV, GenDX B,and received honoraria from: Alimentiv, Janssen-Cilag BV, ESMN, AGA, Mead Johnsson Nutrition, as well as co-founder and grant support: DSCN Research BV, Amsterdam,: AIBiomics BV; and shareholder of: Amstel Biotech BV.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}