{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:00:34Z","timestamp":1787169634991,"version":"build-2736575974"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"10","funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"crossref","award":["U54GM115428"],"award-info":[{"award-number":["U54GM115428"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Objective\u2003The aim of the study is to determine clinical correlates of moderate to severe bronchopulmonary dysplasia (BPD) in preterm infants following surgical necrotizing enterocolitis (NEC).<\/jats:p>\n                  <jats:p>Study Design\u2003This is a retrospective, single-center cohort study comparing patients with moderate to severe BPD to patients with non\/mild BPD among surgical NEC infants. BPD was defined by NIH 2001 consensus definition.<\/jats:p>\n                  <jats:p>Results\u2003Of 92 consecutive neonates with surgical NEC, 77% (71\/92) had moderate\/severe BPD and 22% (21\/92) had non\/mild BPD. The patent ductus arteriosus (PDA) was significantly higher in those developing moderate\/severe BPD (67.6% [48\/71]) than non\/mild BPD (28.6% [6\/21]; p\u2009=\u20090.001). Postoperatively, infants with moderate\/severe BPD had more severe acute kidney injury (AKI; 67.6 [48\/71] vs. 28.6% [6\/21]; p\u2009=\u20090.001), were intubated longer (40.5 [interquartile (IQR): 12, 59] vs. 6 days [IQR: 2, 13]; p &lt;0.001), received more parenteral nutrition (109 [IQR: 77, 147] vs. 55 days [IQR: 19, 70]; p &lt;0.001), developed higher surgical morbidity (46.5 [33\/71] vs. 14.3% [3\/21]; p\u2009=\u20090.008), had more intestinal failure (62.5 vs. 13.3%; p &lt;0.001), required a longer hospital stay (161 [IQR: 112, 186] vs. 64 days [IQR: 20, 91]; p &lt;0.001), and were more likely to need home oxygen. In a multivariable analysis, lower birth weight (OR\u2009=\u20090.3, [95% confidence interval (CI): 0.1\u20130.5]; p\u2009=\u20090.001), PDA (OR\u2009=\u200910.3, [95% CI: 1.6\u201365.4]; p\u2009=\u20090.014), and longer parenteral nutritional days (OR\u2009=\u20098.8; [95% CI: 2.0\u201343.0]; p\u2009=\u20090.005) were significantly and independently associated with higher odds of moderate\/severe versus non-\/mild BPD.<\/jats:p>\n                  <jats:p>Conclusion\u2003Development of moderate\/severe BPD occurred in the majority of preterm infants with surgical NEC in this consecutive series. Preterm infants with moderate\/severe BPD were more likely to have a PDA before NEC. Development of moderate\/severe BPD was associated with significantly greater burden and duration of postoperative morbidity following surgical NEC. Identifying surgical NEC infants at increased risk of moderate\/severe BPD and developing lung protection strategies may improve surgical NEC outcomes.<\/jats:p>\n                  <jats:p>Key Points<\/jats:p>","DOI":"10.1055\/a-1904-9194","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T18:56:05Z","timestamp":1658343365000},"page":"1348-1358","source":"Crossref","is-referenced-by-count":15,"title":["Clinical Correlates of Moderate-to-Severe Bronchopulmonary Dysplasia in Preterm Infants following Surgical Necrotizing Enterocolitis"],"prefix":"10.1055","volume":"41","author":[{"given":"Parvesh M.","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Pippin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengna","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ware","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nelin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaslyn","family":"Paschal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"},{"name":"Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Varshney","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B.","family":"Hillegass","sequence":"additional","affiliation":[{"name":"Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi"},{"name":"Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"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":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/j.1536-4801.2004.tb00868.x","article-title":"Variations in incidence of necrotizing enterocolitis in Canadian neonatal intensive care units","volume":"39","author":"K Sankaran","year":"2004","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"e000316","DOI":"10.1136\/bmjpo-2018-000316","article-title":"Intestinal failure after necrotising enterocolitis: incidence and risk factors in a Swedish population-based longitudinal study","volume":"2","author":"T Sjoberg Bexelius","year":"2018","journal-title":"BMJ Paediatr Open"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"F461","DOI":"10.1136\/archdischild-2017-313113","article-title":"One-year outcomes following surgery for necrotising enterocolitis: a UK-wide cohort study","volume":"103","author":"B SR Allin","year":"2018","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1067\/j.cpsurg.2018.11.005","article-title":"Current status of necrotizing enterocolitis","volume":"56","author":"J Knell","year":"2019","journal-title":"Curr Probl Surg"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1001\/jama.2015.10244","article-title":"Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012","volume":"314","author":"B J Stoll","year":"2015","journal-title":"JAMA"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1542\/peds.55.3.376","article-title":"Acute necrotizing enterocolitis in infancy: a review of 64 cases","volume":"55","author":"T V S\u00e1ntulli","year":"1975","journal-title":"Pediatrics"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.siny.2018.08.004","article-title":"The cost of necrotizing enterocolitis in premature infants","volume":"23","author":"M E Mowitz","year":"2018","journal-title":"Semin Fetal Neonatal Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/1471-2431-13-127","article-title":"Long term healthcare costs of infants who survived neonatal necrotizing enterocolitis: a retrospective longitudinal study among infants enrolled in Texas Medicaid","volume":"13","author":"V Ganapathy","year":"2013","journal-title":"BMC Pediatr"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"101121","DOI":"10.1016\/j.siny.2020.101121","article-title":"Management of neonatal hypotension and shock","volume":"25","author":"C E Schwarz","year":"2020","journal-title":"Semin Fetal Neonatal Med"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1038\/s41390-020-01320-6","article-title":"Severe acute kidney injury in neonates with necrotizing enterocolitis: risk factors and outcomes","volume":"90","author":"P M Garg","year":"2021","journal-title":"Pediatr Res"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1038\/s41390-021-01614-3","article-title":"Brain injury in preterm infants with surgical necrotizing enterocolitis: clinical and bowel pathological correlates","volume":"91","author":"P M Garg","year":"2022","journal-title":"Pediatr Res"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1542\/peds.2004-0569","article-title":"Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis","volume":"115","author":"S R Hintz","year":"2005","journal-title":"Pediatrics"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"151454","DOI":"10.1016\/j.semperi.2021.151454","article-title":"Necrotizing enterocolitis and the gut-lung axis","volume":"45","author":"K A Willis","year":"2021","journal-title":"Semin Perinatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.3389\/fmicb.2015.01085","article-title":"Regulation of lung immunity and host defense by the intestinal microbiota","volume":"6","author":"D R Samuelson","year":"2015","journal-title":"Front Microbiol"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","article-title":"Bronchopulmonary dysplasia","volume":"163","author":"A H Jobe","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00000658-197801000-00001","article-title":"Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging","volume":"187","author":"M J Bell","year":"1978","journal-title":"Ann Surg"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/jp.2011.61","article-title":"Fulminant necrotizing enterocolitis in a multihospital healthcare system","volume":"32","author":"D K Lambert","year":"2012","journal-title":"J Perinatol"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"e463","DOI":"10.1542\/peds.2014-3819","article-title":"Neonatal acute kidney injury","volume":"136","author":"D T Selewski","year":"2015","journal-title":"Pediatrics"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/S2352-4642(17)30069-X","article-title":"Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study","volume":"1","author":"J G Jetton","year":"2017","journal-title":"Lancet Child Adolesc Health"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3389\/fped.2016.00068","article-title":"Assessment of worldwide acute kidney injury epidemiology in neonates: design of a retrospective cohort study","volume":"4","author":"J G Jetton","year":"2016","journal-title":"Front Pediatr"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.clp.2014.05.001","article-title":"Acute kidney injury in the neonate","volume":"41","author":"J G Jetton","year":"2014","journal-title":"Clin Perinatol"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1038\/pr.2017.136","article-title":"Developing a neonatal acute kidney injury research definition: a report from the NIDDK neonatal AKI workshop","volume":"82","author":"M Zappitelli","year":"2017","journal-title":"Pediatr Res"},{"issue":"03","key":"ref24","first-page":"222","article-title":"Assessment of worldwide acute kidney injury, renal angina and epidemiology in critically Ill children (AWARE): a prospective study to improve diagnostic precision","volume":"5","author":"R K Basu","year":"2015","journal-title":"J Clin Trials"},{"issue":"382","key":"ref25","first-page":"427","article-title":"A network algorithm for performing fisher's exact test in r \u00d7 c contingency tables","volume":"78","author":"C Mehta","year":"1983","journal-title":"J Am Stat Assoc"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1038\/s41372-020-00880-z","article-title":"Delay in achieving enteral autonomy and growth outcomes in very low birth weight infants with surgical necrotizing enterocolitis","volume":"41","author":"K McNelis","year":"2021","journal-title":"J Perinatol"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/MPG.0000000000001504","article-title":"Nutritional practices and growth in premature infants after surgical necrotizing enterocolitis","volume":"65","author":"G C Lin","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"06","key":"ref28","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.jpedsurg.2018.02.085","article-title":"Growth morbidity in extremely low birth weight survivors of necrotizing enterocolitis at discharge and two-year follow-up","volume":"53","author":"C R Hong","year":"2018","journal-title":"J Pediatr Surg"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1097\/ALN.0b013e31824f951b","article-title":"Acute kidney injury and extrarenal organ dysfunction: new concepts and experimental evidence","volume":"116","author":"S C Yap","year":"2012","journal-title":"Anesthesiology"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1055\/s-0039-3400311","article-title":"acute kidney injury and bronchopulmonary dysplasia in premature neonates born less than 32 weeks' gestation","volume":"37","author":"M C Starr","year":"2020","journal-title":"Am J Perinatol"},{"issue":"01","key":"ref31","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1038\/s41390-020-0975-6","article-title":"Incomplete resection of necrotic bowel may increase mortality in infants with necrotizing enterocolitis","volume":"89","author":"P M Garg","year":"2021","journal-title":"Pediatr Res"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1203\/PDR.0b013e3182093280","article-title":"New insights into the pathogenesis and treatment of necrotizing enterocolitis: toll-like receptors and beyond","volume":"69","author":"A Afrazi","year":"2011","journal-title":"Pediatr Res"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.jpedsurg.2007.01.023","article-title":"Toll-like receptor 4 plays a role in macrophage phagocytosis during peritoneal sepsis","volume":"42","author":"R J Anand","year":"2007","journal-title":"J Pediatr Surg"},{"issue":"05","key":"ref34","doi-asserted-by":"crossref","first-page":"3070","DOI":"10.4049\/jimmunol.176.5.3070","article-title":"Enterocyte TLR4 mediates phagocytosis and translocation of bacteria across the intestinal barrier","volume":"176","author":"M D Neal","year":"2006","journal-title":"J Immunol"},{"issue":"03","key":"ref35","doi-asserted-by":"crossref","first-page":"859","DOI":"10.4049\/jimmunol.1600618","article-title":"Pulmonary epithelial TLR4 activation leads to lung injury in neonatal necrotizing enterocolitis","volume":"197","author":"H Jia","year":"2016","journal-title":"J Immunol"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3389\/fmicb.2019.00159","article-title":"Elevated gut microbiome-derived propionate levels are associated with reduced sterile lung inflammation and bacterial immunity in mice","volume":"10","author":"X Tian","year":"2019","journal-title":"Front Microbiol"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/pr.2014.48","article-title":"Cytokines associated with necrotizing enterocolitis in extremely-low-birth-weight infants","volume":"76","author":"A Maheshwari","year":"2014","journal-title":"Pediatr Res"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1542\/peds.2008-0526","article-title":"Cytokines associated with bronchopulmonary dysplasia or death in extremely low birth weight infants","volume":"123","author":"N Ambalavanan","year":"2009","journal-title":"Pediatrics"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1904-9194.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:50:25Z","timestamp":1730803825000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1904-9194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,20]]},"references-count":38,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,7,4]]},"published-print":{"date-parts":[[2024,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1904-9194","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,7,20]]},"published":{"date-parts":[[2022,7,20]]}}}