95 - Placental abruption and the risk for necrotizing enterocolitis

The National Inpatient Sample (NIS) datasets produced by the Health Cost and Utilization Project (HCUP) for the years 2016-2018 were used to extract this sample. Newborn infants of all gestational age (GA) and birth weight (BW) categories were included. The odds ratios (OR) of developing NEC in association with placental abruption were calculated using chi square test. Adjusted odds ratios (aOR) of the association of NEC with placental abruption were calculated using logistic regression models to control for confounding variables that may independently contribute to the development of NEC such as maternal hypertension, diabetes, anemia, or chorioamnionitis, placenta previa, nuchal cord, cord prolapse, neonatal sex, BW, GA, race, early or late sepsis, respiratory distress syndrome, pulmonary hypertension or hemorrhage, congenital heart diseases, congenital diaphragmatic hernia, birth asphyxia, and chromosomal disorders.

Results: Sample included 11,597,756 newborn infants of which 48.6% were females, 46.5% were Caucasians, 96.7% were singleton, 1.6% were small for gestational age, and 32.9% were Cesarean deliveries. Infants < 1500 BW were 1.4% and those < 28 wk GA were 0.84%. Placental abruption occurred in 0.16% of the infants and NEC occurred in 0.18%. NEC occurred in 2.5% in infants suffered placental abruption compared to 0.17% in infants without placental abruption, aOR 1.6 (95%CI: 1.4-1.8), p < 0.001. In a subsample of infants < 1500g, placental abruption occurred in 2.7% and NEC occurred in 6.9%. NEC occurred in 7.4% in infants suffered placental abruption compared to 6.8% in infants without placental abruption, aOR 1.3 (95%CI: 1.1-1.4), p < 0.001.

Conclusion(s): Placental abruption is associated with increased incidence of NEC. The current findings would be helpful to consider during enteral feeding in preterm infants.