{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:13:14Z","timestamp":1773285194559,"version":"3.50.1"},"reference-count":54,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"name":"Mayo Clinic Children's Research Center","award":["n.a."],"award-info":[{"award-number":["n.a."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003We characterize the most recent natural history of necrotizing enterocolitis (NEC), as this is an essential first step in guiding the prevention and treatment of this disease in the present day.<\/jats:p><jats:p>\n            Study Design\u2003We performed a retrospective cohort study of neonates who were born at 23 to 29 weeks' gestation and birth weight &lt;1,500\u2009g who received care from the Pediatrix Medical Group between 2004 and 2019. We assessed the incidence of medical and surgical NEC and the patterns of initial antibiotic treatment to develop a contemporary cohort for further analysis. Among patients discharged between 2015 and 2019, we characterized the stage-specific risk factors for patients diagnosed with medical or surgical NEC, as well as patterns of disease onset, progression, biomarkers, and outcomes. We used the same approach to characterize patients diagnosed with suspected NEC.<\/jats:p><jats:p>\n            Results\u2003Among 34,032 patients in the contemporary cohort, 1,150 (3.4%) were diagnosed with medical NEC and 543 (1.6%) were diagnosed with surgical NEC. The temporal pattern of disease onset was different for medical and surgical NEC, with gestational age\u2013 and birth weight\u2013specific risk disparities emerging earlier in surgical NEC. Thirty-day mortality was much greater among surgical NEC patients (medical NEC 16.4% vs. surgical NEC 43.0%), as were rates of various in-hospital and long-term outcomes. Suspected NEC was diagnosed in 1,256 (3.7%) patients, among whom risk factors and disease onset, progression, and outcomes closely resembled those of medical NEC.<\/jats:p><jats:p>\n            Conclusion\u2003Analyzing data from a contemporary cohort enabled us to characterize the current, stage-specific natural history of NEC, including novel insights into suspected NEC. Future studies could leverage this cohort to characterize how specific patient characteristics, care processes, or biomarkers may influence or predict disease outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1851-1692","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T22:42:07Z","timestamp":1652395327000},"page":"e435-e445","source":"Crossref","is-referenced-by-count":7,"special_numbering":"S","title":["Necrotizing Enterocolitis in Very Low Birth Weight Neonates: A Natural History Study"],"prefix":"10.1055","volume":"41","author":[{"given":"Kristin C.","family":"Mara","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reese H.","family":"Clark","sequence":"additional","affiliation":[{"name":"Center for Research, Education and Quality, Pediatrix Medical Group, Sunrise, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Carey","sequence":"additional","affiliation":[{"name":"Division of Neonatal Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1056\/NEJMra1005408","article-title":"Necrotizing enterocolitis","volume":"364","author":"J Neu","year":"2011","journal-title":"N Engl J Med"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1001\/jamapediatrics.2016.2708","article-title":"New medical and surgical insights into neonatal necrotizing enterocolitis: a review","volume":"171","author":"B L Frost","year":"2017","journal-title":"JAMA 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Murphy","year":"2020","journal-title":"Am J Perinatol"},{"issue":"11","key":"ref40","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1016\/j.jpedsurg.2012.08.011","article-title":"Treatment of necrotizing enterocolitis: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review","volume":"47","author":"C D Downard","year":"2012","journal-title":"J Pediatr Surg"},{"issue":"06","key":"ref41","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1097\/INF.0000000000003034","article-title":"Antibiotic safety and effectiveness in premature infants with complicated intraabdominal infections","volume":"40","author":"M J Smith","year":"2021","journal-title":"Pediatr Infect Dis J"},{"issue":"04","key":"ref42","doi-asserted-by":"crossref","first-page":"e370","DOI":"10.1097\/SLA.0000000000005099","article-title":"Initial laparotomy versus peritoneal drainage in extremely low birth weight infants with surgical necrotizing enterocolitis or 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