Biomarker signals deadly NEC in preemies

Researchers have discovered a reliable biomarker for necrotizing enterocolitis (NEC), a potentially deadly bowel infection that affects primarily extremely low-birth-weight (LBW) infants.

In a recent study, researchers discovered that a decreased number of reticulated platelets in premature infants is a highly reliable sign that NEC will ensue, allowing for early intervention and treatment. They also found that elevated intestinal alkaline phosphatase (iAP) somewhat reliably heralds the development of the condition.

Investigators from Loyola University in Illinois studied 177 infants born at or before 32 weeks’ gestation and weighing 1,500 grams or less. Starting at 3 days of age, the researchers collected 5 weekly whole blood samples and measured reticulated platelets and iAP. If NEC occurred, they obtained additional samples.

Fifteen infants (8.5%) developed NEC, of which 40% required surgery and 20% died. Fourteen of those who developed NEC (93%) had low reticulated platelets (≤2.3%) and 9 (60%) had high iAP (>0 U/L).

According to the National Institutes of Health, about 7% of extremely LBW infants develop NEC and almost one-third who do, die. Knowing which infants are at risk allows physicians to make changes to blood transfusion practices, feeding patterns, and treatment, which can prevent the disorder and significantly reduce the incidence of the condition.

Although the exact cause is unknown, experts believe that NEC arises from a combination of factors, which may include decreased blood flow to the bowel, feeding patterns, infection, mechanical injury, or abnormal immune response. 

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