Katsumi Mizuno, Yuka S Wada, Motoichiro Sakurai, Yuki Tani, Masafumi Miyata, Jun Shindo, Shigeru Nishimaki, Hiroki Den
{"title":"母乳库数据库登记NEC病例分析。","authors":"Katsumi Mizuno, Yuka S Wada, Motoichiro Sakurai, Yuki Tani, Masafumi Miyata, Jun Shindo, Shigeru Nishimaki, Hiroki Den","doi":"10.3389/fped.2025.1679676","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) remains a major cause of morbidity and mortality in extremely low birth weight infants (ELBWIs), despite widespread donor human milk (DHM) use. This study examined NEC cases among DHM recipients to explore potential contributing factors.</p><p><strong>Methods: </strong>We retrospectively analyzed 1,425 infants registered in Japan's human milk bank database (2018-2023). NEC cases at Bell stage ≥ II were confirmed by attending physicians. Infants who received DHM only after NEC onset were excluded. Cases were categorized by onset timing and associated clinical factors.</p><p><strong>Results: </strong>Among 1,324 very low birth weight infants, 21 (1.58%) developed NEC, with 20 requiring surgical intervention. Median gestational age and birth weight were 25.1 weeks and 637 g, respectively. NEC onset was classified as follows: within 7 days of birth (<i>n</i> = 5), after 2 months (<i>n</i> = 5), after formula or fortifier use (<i>n</i> = 6), associated with hemodynamic changes (<i>n</i> = 7), or of unknown etiology (<i>n</i> = 4). Common factors included symptomatic PDA, congenital heart disease, infection, formula exposure, and ophthalmologic procedures.</p><p><strong>Conclusion: </strong>NEC can develop despite DHM use, often in association with early infections, PDA, or fortification. Strategies to further reduce NEC incidence should include management of hemodynamic instability, delayed formula introduction, and use of exclusive human milk-based diets. Further research should explore potential roles of ophthalmologic interventions and human milk fortifiers in NEC development.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1679676"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484215/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of NEC cases registered in the human milk bank database.\",\"authors\":\"Katsumi Mizuno, Yuka S Wada, Motoichiro Sakurai, Yuki Tani, Masafumi Miyata, Jun Shindo, Shigeru Nishimaki, Hiroki Den\",\"doi\":\"10.3389/fped.2025.1679676\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) remains a major cause of morbidity and mortality in extremely low birth weight infants (ELBWIs), despite widespread donor human milk (DHM) use. This study examined NEC cases among DHM recipients to explore potential contributing factors.</p><p><strong>Methods: </strong>We retrospectively analyzed 1,425 infants registered in Japan's human milk bank database (2018-2023). NEC cases at Bell stage ≥ II were confirmed by attending physicians. Infants who received DHM only after NEC onset were excluded. Cases were categorized by onset timing and associated clinical factors.</p><p><strong>Results: </strong>Among 1,324 very low birth weight infants, 21 (1.58%) developed NEC, with 20 requiring surgical intervention. Median gestational age and birth weight were 25.1 weeks and 637 g, respectively. NEC onset was classified as follows: within 7 days of birth (<i>n</i> = 5), after 2 months (<i>n</i> = 5), after formula or fortifier use (<i>n</i> = 6), associated with hemodynamic changes (<i>n</i> = 7), or of unknown etiology (<i>n</i> = 4). Common factors included symptomatic PDA, congenital heart disease, infection, formula exposure, and ophthalmologic procedures.</p><p><strong>Conclusion: </strong>NEC can develop despite DHM use, often in association with early infections, PDA, or fortification. Strategies to further reduce NEC incidence should include management of hemodynamic instability, delayed formula introduction, and use of exclusive human milk-based diets. Further research should explore potential roles of ophthalmologic interventions and human milk fortifiers in NEC development.</p>\",\"PeriodicalId\":12637,\"journal\":{\"name\":\"Frontiers in Pediatrics\",\"volume\":\"13 \",\"pages\":\"1679676\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484215/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fped.2025.1679676\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1679676","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Analysis of NEC cases registered in the human milk bank database.
Background: Necrotizing enterocolitis (NEC) remains a major cause of morbidity and mortality in extremely low birth weight infants (ELBWIs), despite widespread donor human milk (DHM) use. This study examined NEC cases among DHM recipients to explore potential contributing factors.
Methods: We retrospectively analyzed 1,425 infants registered in Japan's human milk bank database (2018-2023). NEC cases at Bell stage ≥ II were confirmed by attending physicians. Infants who received DHM only after NEC onset were excluded. Cases were categorized by onset timing and associated clinical factors.
Results: Among 1,324 very low birth weight infants, 21 (1.58%) developed NEC, with 20 requiring surgical intervention. Median gestational age and birth weight were 25.1 weeks and 637 g, respectively. NEC onset was classified as follows: within 7 days of birth (n = 5), after 2 months (n = 5), after formula or fortifier use (n = 6), associated with hemodynamic changes (n = 7), or of unknown etiology (n = 4). Common factors included symptomatic PDA, congenital heart disease, infection, formula exposure, and ophthalmologic procedures.
Conclusion: NEC can develop despite DHM use, often in association with early infections, PDA, or fortification. Strategies to further reduce NEC incidence should include management of hemodynamic instability, delayed formula introduction, and use of exclusive human milk-based diets. Further research should explore potential roles of ophthalmologic interventions and human milk fortifiers in NEC development.
期刊介绍:
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.