64: Antibiotic Exposure and Development of Necrotizing Enterocolitis in Very Preterm Neonates in Canada
Bibliographic record
Abstract
Necrotizing enterocolitis (NEC) is a common causes of morbidity and mortality in NICUs. Prolonged duration of empiric antibiotic therapy alters the normal gut flora and may increase the risk of NEC; however, such an association needs to be investigated in larger cohorts. To examine the association between the duration of antibiotic exposure and the development of stage 2 or 3 NEC in very preterm neonates. A retrospective case-control study of neonates born at <29 weeks and admitted between 2010 and 2013 was conducted using data from the Canadian Neonatal Network. Infants were excluded if they had culture-proven sepsis. Baseline demographics were compared between those who developed NEC and those who did not. The number of NPO and empiric antibiotic days until the development of NEC were calculated for cases and compared with those for the two controls (GA, birth weight and sex-matched) in each cluster for the same postnatal age at which each case developed NEC. A total of 224 cases of NEC and 447 controls were studied. There were no differences in chorioamnionitis, SNAP-II scores, PDA or inotrope use between those who developed NEC and those who did not. A multiple regression analysis controlling for NPO days and antenatal steroid use revealed that the duration of antibiotic exposure was higher in the NEC cases as compared with controls (P<0.01). Antibiotic treatment of more than four days was associated with significantly higher adjusted odds ratios of NEC. Empiric antibiotic exposure of more than four days in very preterm neonates of <29 weeks was associated with an increased risk of NEC after controlling for confounders. Further prospective studies on reasons for empiric usage of antibiotics and its association with neonatal morbidities is warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".