72 - Postnatal dynamics of fecal calprotectin in hospitalized preterm infants with and without gastrointestinal disorders

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 72
Publication Number: 72.235

Luyang Hong, Children's hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Yihuang Huang, Children's hospital of Fudan university, Shanghai, Shanghai, China (People's Republic); Siyuan Jiang, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Junyan Han, Children' Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Shujuan Li, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Lan Zhang, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Xincheng Cao, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Weiyin Yu, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Yi Yang, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Yun Cao, Children's Hospital of Fudan University, Shanghai, PCR, Shanghai, Shanghai, China (People's Republic)

Presenting Author(s)

Luyang Hong

postgraduate student & resident physician
Children's hospital of Fudan University
Shanghai, Shanghai, China (People's Republic)

Background:

Fecal calprotectin (FC) has emerged as a reliable biomarker for evaluating gastrointestinal inflammation in adults and elder children. However, the postnatal dynamics of FC and its' use in NEC diagnosis among premature neonates were undetermined due to limited data.

Objective: To illustrate the postnatal dynamic pattern and clinical associations of FC in hospitalized very preterm infants and examine its alterations in gastrointestinal disorders.

Design/Methods: We performed a prospective observational cohort study in infants with a gestational age of < 32 weeks or birth weight < 1500 g with weekly feces collection. FC levels were compared between infants with and without necrotizing enterocolitis (NEC). Among infants without NEC and sepsis, FC levels were compared between those with and without feeding intolerance (FI).

Results:

A total of 1,086 fecal samples were collected from 194 preterm infants (20 with and 174 without NEC). Postnatal FC levels of non-NEC infants followed an age-dependent patterned progression. Compared to non-NEC infants, the FC levels of NEC patients were higher in the pre-NEC period and at NEC onset. The cut-off value to distinguish NEC-onset from non-NEC infants was 1237 ug/g (sensitivity: 93.3%, specificity: 38.9%). The cut-off value to distinguish NEC-onset from sepsis-onset was 238 ug/g (sensitivity: 93.3%, specificity: 75%). Among infants without NEC or sepsis, infants with FI had lower FC levels throughout hospitalization; a delay in the increase of FC levels was associated with extended days to reach full enteral feeding.

Conclusion(s): Postnatal FC dynamics among premature infants followed a patterned progression but were disturbed in NEC patients. Due to the high variations, the use of FC levels in NEC diagnosis should be implemented with caution in clinical practice. The associations between FC and feeding conditions among premature infants warrant further research.