{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:11:59Z","timestamp":1784895119583,"version":"3.55.0"},"reference-count":45,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"crossref","award":["5U54GM115428"],"award-info":[{"award-number":["5U54GM115428"]}],"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":[[2026,4]]},"abstract":"<jats:p>This study aimed to assess the relationship between placental lesions, antibiotic exposure duration, and necrotizing enterocolitis (NEC) severity in preterm infants.<\/jats:p>\n                  <jats:p>In this single-center, case\u2013control study, 107 infants with NEC and 130 controls were grouped by antibiotic exposure after birth: \u22643 or &gt;3 days.<\/jats:p>\n                  <jats:p>Of 212 infants, 103 (48.5%) received antibiotics for \u22643 days, while 109 (51.5%) received antibiotics for &gt;3 days. Multivariate regression analysis demonstrated that prolonged antibiotic duration (&gt;3 vs. \u22643 days) was significantly associated with increased severity of NEC, with adjusted odds ratios (aORs) of 2.65 (95% confidence interval [CI]: 1.36\u20135.16; p\u2009=\u20090.004) for medical NEC and 3.36 (95% CI: 1.56\u20137.23; p\u2009=\u20090.002) for surgical NEC. However, prolonged antibiotic duration was not significantly associated with overall mortality (aOR\u2009=\u20091.16, 95% CI: 0.58\u20132.34; p\u2009=\u20090.7). Among infants diagnosed with NEC (n\u2009=\u200997), antibiotic duration of &gt;3 days significantly increased the odds of mortality (aOR\u2009=\u20097.34, 95% CI: 1.94\u201348.3; p\u2009=\u20090.011) but was not significantly associated with NEC severity (aOR\u2009=\u20091.20, 95% CI: 0.49\u20132.94; p\u2009=\u20090.7). Among 64 infants with acute histologic chorioamnionitis, 37 (58%) received antibiotics for &gt;3 days. Longer antibiotic exposure was linked to higher risks of medical NEC (79 vs. 38%; p\u2009=\u20090.021) and surgical NEC (62 vs. 38%; p\u2009=\u20090.021) compared with shorter exposure. In 134 infants with maternal vascular malperfusion (MVM), prolonged antibiotics were also associated with increased risks for medical (60 vs. 36%; p\u2009=\u20090.007) and surgical NEC (67 vs. 36%; p\u2009=\u20090.007). Concordance between clinical and pathologic chorioamnionitis was moderate (first-order agreement coefficient [AC1]\u2009=\u20090.60), while agreement for pregnancy-induced hypertension versus MVM was minimal (AC1\u2009=\u20090.07).<\/jats:p>\n                  <jats:p>Prolonged antibiotic exposure (&gt;3 days) in infants with chorioamnionitis or MVM is most likely associated with increased NEC severity. Limiting antibiotic duration may reduce severe NEC risk in preterm infants.<\/jats:p>","DOI":"10.1055\/a-2663-5723","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:29:34Z","timestamp":1753316974000},"page":"621-635","source":"Crossref","is-referenced-by-count":3,"title":["Association of Placental Pathology and Antibiotic Exposure after Birth with the Severity of Necrotizing Enterocolitis in Preterm Infants: A Case\u2013Control Study"],"prefix":"10.1055","volume":"43","author":[{"given":"Parvesh M.","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbin","family":"Riddick","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Abu Yusuf","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aubrey","family":"Rebentisch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Infectious Disease, Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","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"}]},{"given":"Padma P.","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,8,4]]},"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 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