Prenatal Corticosteroid Use Improves the Severity and Complications of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Clinical Study in China

Prenatal Corticosteroid Use Improves the Severity and Complications of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Clinical Study in China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Prenatal Corticosteroid Use Improves the Severity and Complications of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Clinical Study in China Chengyu Wang, Zhuo Na, Yanbin An, Arigonggaowa Arigong, Cai Cheng, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7698735/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Our study is a retrospective multicenter observational cohort study to investigate effect of the use of antenatal corticosteroids (ACS) in preterm infants on the severity of necrotizing enterocolitis (NEC) and its associated complications. We collect clinical data from 443 preterm infants with gestational age(GA) of less than 37 weeks who were diagnosed with NEC in four hospitals across various provinces in China from June 2020 to June 2024. The infants were categorized into an exposed group and a non-exposed group based on whether they received prenatal corticosteroid therapy. 213 preterm infants (48.08%) had received ACS therapy. When compared to the non-exposed group, the severity of NEC in the exposed group demonstrated a statistically significant difference (p=0.005). In the univariate regression analysis, ACS therapy was identified as a significant protective factor against the occurrence of hsPDA (OR=0.612, CI 0.385-0.974), BPD (OR=0.611, CI 0.377-0.989), and the need for surgical intervention (OR=0.609, CI 0.384-0.967). After adjusting for multiple confounding factors, ACS continued to demonstrate its protective effect against the severity of NEC (OR=0.269, CI 0.125-0.581). Therefor , ACS can reduce the severity of NEC and lower the incidence of hsPDA, BPD, and the necessity for surgical in preterm infants. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research prenatal corticosteroids necrotizing enterocolitis preterm infants severity protective effect Figures Figure 1 Introduction Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease that occurs during the neonatal period and is a significant cause of neonatal mortality, particularly among preterm infants [1] . The incidence of NEC in neonatal intensive care units(NICU) is reported to range from 2% to 5%. With the notable increase in the survival rate of preterm infants, there is a concomitant rise in the incidence of NEC [2] . Consequently, early prevention and management of NEC are crucial to reducing mortality and preventing long-term adverse complications in preterm infants. Current research indicates that the occurrence of NEC is influenced by various maternal and neonatal risk factors, including gestational hypertension [3] , chorioamnionitis, maternal prenatal antibiotic exposure, intrauterine growth restriction (IUGR), preterm birth, low BW, hypoxia, infection, anemia, and blood transfusion [4-6] . Furthermore, the use of ACS has been shown to mitigate the risk of various complications in preterm infants, such as respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and NEC. However, the relationship between ACS usage and the incidence and severity of NEC is intricate and influenced by numerous factors [2] . Therefore, this study aims to analyze the impact of ACS administration on the severity and complications of NEC, with the objective of providing references for the prevention and treatment of this condition. Materials and Methods 1.1 General Information A total of 443 preterm infants diagnosed with NEC at Stage I or above were included in this study, which was conducted between June 2020 and June 2024 across four centers: Shanghai Children's Hospital, Jiangxi Children's Hospital, Quanzhou Children's Hospital, and Inner Mongolia Maternal and Child Health Hospital. The diagnosis was established using the modified Bell staging criteria [7] . The infants were monitored until discharge, transfer, or death, whichever occurred first. Inclusion criteria: (1) Bell stage I or above; (2) GA less than 37 weeks; Exclusion criteria: (1) Developmental malformations of the digestive tract; (2) Congenital inherited metabolic disorders; (3) Incomplete clinical data. Based on whether they received prenatal corticosteroid treatment, the participants were divided into the exposed group (n=213) and the non-exposed group (n=230).（Figure 1） This study has been reviewed and approved by the Medical Ethics Committee of Shanghai Children's Hospital (Ethics Approval Number: 2022RY062), and written informed consent has been obtained from the guardians of the pediatric patients. 1.2 Clinical Indicators A retrospective analysis was conducted on the clinical data of children who received ACS and those who did not, focusing on extracting potential risk factors and comorbidities that could influence the occurrence and outcomes of NEC, including the following: (1) Maternal conditions during pregnancy: such as gestational hypertension, chorioamnionitis, placental abruption, placenta previa, premature rupture of membranes, etc. (2) General information of the pediatric patient: such as GA at birth, weight, ethnicity, gender, medical institution, duration of hospitalization, and outcome, etc. (3) Postnatal clinical conditions: such as whether resuscitation was performed at birth, Apgar scores at 1 and 5 minutes, NEC grade, age at onset, respiratory support method at onset, whether full enteral feeding was achieved, feeding method at onset and any blood transfusion within one week before the onset of the disease, etc. (4) Comorbid conditions: such as whether there was hsPDA after birth, whether there was intracranial hemorrhage, sepsis, shock, gastrointestinal perforation, surgery, BPD, etc., before the onset of the disease, etc. (5) Laboratory tests: such as white blood cell count, red blood cell count, platelet count, and hemoglobin count at the onset of the disease; hematocrit at the onset of the disease, and the highest serum creatinine level during NEC, etc. 1.3 Statistical Processing. Data analysis was conducted using SPSS version 27.0. Categorical data are presented as n (%), with intergroup comparisons performed using the χ² test or Fisher's exact test. Normally distributed continuous data are expressed as mean ± standard deviation (x̄ ± s), and intergroup comparisons were conducted using the t-test. For non-normally distributed continuous data, results are presented as M (P25, P75), with intergroup comparisons performed using the Mann-Whitney U test. A P-value of less than 0.05 was deemed statistically significant. Risk factors identified as statistically significant in the univariate analysis were subsequently analyzed using multivariate logistic regression analysis. Results 2.1 Baseline data From June 2020 to June 2024, a total of 680 neonates diagnosed with NEC at the Department of neonatology in four hospitals were included in this study. Among them, 443 preterm infants met the inclusion criteria and were enrolled for analysis. The average GA of this cohort was 32.08 ± 2.98 weeks, and the average BW was 1.685 ± 0.573 kg. Of the participants, 268 (60.50%) were male, 21 were of Mongolian descent, and 1 was of Manchu descent, all from the Inner Mongolia Maternity and Child Health Care Hospital, which accounted for 18.49% of the total number of participants enrolled at that institution.There were 101 (22.80%) mothers of the infants who had gestational hypertension, 29 (13.32%) who had chorioamnionitis, and 213 (48.08%) infants who received ACS treatment prenatally. The median age of onset was 11.0 days, with a P25~P75 range of 5.0 to 20.0 days. Preterm infants with a GA of less than 34 weeks accounted for 48.98% of all patients. At the onset of NEC, 56.79% of the infants required ventilator-assisted ventilation. Of these, 156 infants (38.42%) achieved full enteral feeding, while only 93 infants were exclusively breastfed, representing 22.91% of the total. Among the total population of infants studied, 87 (20.96%) were diagnosed with bronchopulmonary dysplasia (BPD). Additionally, 34.99% of the infants presented with hemodynamically significant patent ductus arteriosus (hsPDA) shortly after birth. Concurrently, 169 infants were diagnosed with sepsis, representing 38.15% of the total cohort. The advancements in molecular biology have significantly propelled progress in medical research and treatment. A total of 96 children (21.76%) underwent surgery, of which 31 children (32.29% of all surgical cases) received primary intestinal anastomosis, while 66.67% underwent enterostomy. There were 23 deaths, accounting for 5.19% of the cases. The median hospital stay for all preterm infants was 35.0 (21.00-58.00) days.（Table 1） 2.2 The impact of ACS on the severity of NEC In the cohort subjected to ACS treatment, a total of 126 children were diagnosed with stage II or higher NEC, representing 59.15% of the exposed group. Among these, 28 children were diagnosed with stage III NEC, accounting for 13.15% of the exposed group. In contrast, the proportions in the non-exposed group were 73.04% and 20.43%, respectively. Therefore, the difference between the exposed and non-exposed groups was statistically significant, with a p-value of 0.005. 2.3 The Impact of ACS on Complications in Preterm Infants In the exposed group, 17.37% of infants underwent surgery, demonstrating a statistically significant difference compared to 25.65% in the non-exposed group (p=0.035). Additionally, significant differences were observed between the two groups regarding medical institutions (p=0.000), GA (p=0.024), the presence of hsPDA after birth (p=0.037), the occurrence of BPD after birth (p=0.044), and peak serum creatinine (SCr) levels during NEC (p=0.018), with all p-values being less than 0.05, indicating statistical significance. This suggests that the use of prenatal steroids significantly influences the severity of NEC, the decision for surgery following NEC diagnosis, as well as the incidence of hsPDA and BPD after birth, and serum creatinine levels during NEC. Furthermore, significant differences in the use of ACS were noted among medical institutions across different regions and GAs. Quanzhou Children's Hospital exhibited the highest ACS usage rate among preterm infants, reaching 60.00%, whereas the Inner Mongolia Maternal and Child Health Hospital reported a relatively low usage rate of only 34.45%. The ACS usage rates at Jiangxi Children's Hospital and Shanghai Children's Hospital were 41.35% and 57.39%, respectively. Additionally, the ACS usage rates for extremely preterm infants (GA <28 weeks) and late preterm infants (GA 34 weeks ≤ <37 weeks) were 40.78% and 40.69%, respectively, while the rates for very preterm infants (GA 28 weeks ≤ <32 weeks) and early preterm infants (GA 32 weeks ≤ <34 weeks) exceeded half, at 50.30% and 60.24%, respectively (Table 2). A univariate logistic regression analysis was conducted to examine the relationship between ACS administration and postnatal complications and outcomes in preterm infants. The results indicated that ACS administration significantly reduced the incidence of several adverse outcomes, including hsPDA (OR = 0.612, 95% CI: 0.385–0.974), BPD (OR = 0.611, 95% CI: 0.377–0.989), and the need for surgical intervention (OR = 0.609, 95% CI: 0.384–0.967). These findings suggest that ACS may play a crucial role in decreasing the incidence of postnatal complications in preterm infants (Table 3) 2.4 NEC risk factors Through χ² and non-parametric tests, we conducted a univariate screening of potential risk factors that may influence both the occurrence and severity of NEC. The results indicated that the p-values for various factors, including medical institution (p=0.000), ethnicity (p=0.007), chorioamnionitis (p=0.000), prenatal steroid use (p=0.050), premature rupture of membranes (p=0.038), GA (p=0.000), BW (p=0.002), Apgar scores at 1 minute and 5 minutes (p=0.003 and p=0.002, respectively), age at onset (p=0.006), respiratory support method at onset (p=0.000), achievement of full enteral feeding at onset (p=0.025), feeding method (p=0.001), presence of intracranial hemorrhage before onset (p=0.006), presence of hsPDA after birth (p=0.000), absolute white blood cell count at onset (p=0.010), absolute platelet count at onset (p=0.000), and SCr level during NEC (p=0.000) were all less than 0.05, indicating statistically significant differences. These factors are identified as risk factors influencing the severity of NEC, while sepsis (p=0.000), shock (p=0.000), gastrointestinal perforation (p=0.000), and BPD (p=0.001) are recognized as severe complications associated with NEC (Table 4). (1) The postnatal clinical condition influences the severity of NEC. Further analysis of the data revealed that the GA and BW for NEC stage III and above were 30.57 (27, 33.71) weeks and 1.5 (1.1, 1.9) kg, respectively. In contrast, for NEC stage II, the values were 33.00 (30.0, 35.42) weeks and 1.75 (1.3, 2.2) kg. Additionally, among infants with NEC stage III and above, the 1-minute Apgar score was 8.0 (7.0, 9.0), which is lower than the scores of 9.0 (8.0, 9.0) for NEC stages I and II. Regarding the age of onset, the median age for Stage I NEC is 14.0 (6.5, 22.0) days, while for Stage II and Stage III NEC, it is 10.0 (5.0, 19.0) days and 9.0 (4.0, 13.0) days, respectively. Therefore, lower GA, lower BW, and lower 1-minute Apgar scores correlate with an earlier age of onset and a greater likelihood of developing NEC, as well as a potential increase in severity. Furthermore, the method of feeding is a significant factor affecting the severity of NEC. The incidence rates of stage II and stage III NEC in breastfed infants are 20.00% and 23.08%, respectively. For those receiving mixed feeding, the rates are 37.50% and 12.31%. In contrast, the rates in preterm infants on artificial feeding are 69.5% and 64.61%, indicating that infants on artificial feeding are at a higher risk of developing NEC and experiencing more severe conditions. (2) Auxiliary examinations can predict the severity of NEC. Lower absolute values of white blood cells and platelets at disease onset, as well as higher peak serum creatinine levels during NEC, indicate greater disease severity. For stage III and above NEC, the median absolute white blood cell count at onset is 8.080 (4.0, 13.0) × 10 9 /L, the median platelet count is 189.000 (115.0, 318.5) × 10 9 /L, and the peak serum creatinine is 45.00 (31.80, 57.30) μmol/L. Furthermore, higher stages of NEC are associated with an increased likelihood of intracranial hemorrhage detected by cranial ultrasound prior to disease onset. (3) Results of Multivariate Logistic Regression Analysis. Through univariate analysis, statistically significant factors influencing both the occurrence and severity of NEC were identified. Subsequently, multivariate logistic regression models were utilized to conduct a comprehensive regression analysis. a) ACS univariate regression analysis. In the univariate regression model, when comparing suspected (Stage I) NEC to Stage II NEC, the regression coefficient for ACS was -0.550, which was statistically significant at the 0.05 level (z = -2.560, p = 0.010 < 0.05). This corresponds to an odds ratio (OR) of 0.577, indicating that for each unit increase in ACS, the risk of developing Stage II NEC decreases by a factor of 0.577. Similarly, for Stage III NEC, the OR for ACS was 0.425, with a 95% confidence interval (CI) ranging from 0.240 to 0.751. These findings further illustrate that ACS acts as a protective factor against the occurrence and severity of NEC, thereby reducing both the risk of developing NEC and its severity. b) Regression analysis adjusted for GA, BW, sex, and regional confounding factors. When adjusting solely for GA, BW, sex, and region, the analysis reveals that, in comparison to stage I NEC, certain factors in stage II NEC exert a negative influence on its occurrence. Specifically, ethnicity ( OR = 0.242, CI: 0.094–0.626), healthcare institution (OR = 0.777, CI: 0.633–0.952), and the application of ACS (OR = 0.515, CI: 0.332–0.801) are identified as significant negative predictors. Furthermore, in the context of stage III NEC, GA (OR = 0.948, CI: 0.920–0.977), the type of medical institution (OR = 0.412, CI: 0.304–0.558), and ACS (OR = 0.286, CI: 0.152–0.538) are all associated with a decreased likelihood of developing stage III NEC and beyond. c) Regression analysis adjusting for confounding factors including chorioamnionitis, presence of hsPDA after birth, feeding methods before onset, and respiratory support methods. After adjusting for GA, BW, gender, and region, further regression analysis was conducted by additionally accounting for the presence of chorioamnionitis, postnatal hsPDA, feeding methods prior to the onset of symptoms, and respiratory support methods prior to the onset of symptoms. The results indicated that chorioamnionitis (OR=5.024, CI: 1.388–18.181), hsPDA (OR=2.381, CI: 1.011–5.607), and respiratory support methods prior to symptom onset (OR=1.851, CI: 1.009–3.394) positively influenced the severity of NEC. This suggests that for each unit increase in these three factors, the risk of NEC severity increases by 5.024 times, 2.381 times, and 1.851 times, respectively. Conversely, ACS (OR=0.269, CI: 0.125–0.581) remains a protective factor against the severity of NEC (Table 5). Discussion In this multicenter retrospective study, we found that ACS could ameliorate the severity of NEC and reduce the risk of complications such as BPD and hsPDA. Additionally, factors such as GA, age at onset, white blood cell count, platelet count, serum creatinine levels, and the occurrence of intracranial hemorrhage were identified as significant predictors of NEC severity. 3.1 The impact of ACS on the severity of NEC The results of this study indicate that, after adjusting for multiple confounding factors, ACS (OR = 0.269, CI: 0.125–0.581) is a protective factor against the occurrence and severity of NEC. This study demonstrates that ACS enhances lung maturity and reduces intestinal inflammation. ACS exerts protective effects by promoting the maturation of intestinal epithelial cells, enhancing mucus secretion, regulating the intestinal microbiota, and modulating immune responses, such as reducing Toll-like receptor 4 (TLR4) signaling pathway activation, which aids in intestinal development and microbial colonization [ 8 , 9 ] . These findings are corroborated by relevant studies both domestically and internationally. For instance, among 16,338 very low BW infants registered in the Korean Neonatal Network, ACS significantly reduces the risk of NEC requiring surgery [ 10 ] . A Japanese neonatal study [ 11 ] revealed that in preterm infants with GA of less than 32 weeks and BW under 1500g, ACS treatment significantly reduced the risk of mortality (OR = 0.61; 95% CI 0.53–0.70), respiratory distress syndrome (OR = 0.71; 95% CI 0.67–0.76), cerebral palsy (OR = 0.85; 95% CI 0.72–0.99), and NEC (P = 0.04). However, the study also indicated that the timing of ACS administration is crucial. The optimal effect of ACS can be observed when administered within 7 days prior to preterm birth, a timing that maximizes its benefits on neonatal outcomes. Both the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG) recommend a single course of antenatal corticosteroids for pregnant women at risk of preterm birth between 24 and 34 weeks of gestation [ 9 ] . However, some studies indicate that the relationship between ACS use and NEC is not entirely straightforward. In certain instances, ACS administration may not influence the incidence of NEC, and multiple courses or high doses of steroid hormones could potentially elevate the risk of NEC [ 8 , 12 ] . A study involving infants with GA between 34 and 37 weeks revealed that following ACS administration, the overall respiratory morbidity in newborns decreased (16% vs. 28%, p = 0.04). Nevertheless, no significant differences were observed in the incidence of NEC, hypoglycemia, intraventricular hemorrhage, sepsis, and mortality (p > 0.05) [ 13 ] . Our study did not conduct a statistical analysis regarding the dosage and timing of ACS; therefore, further research is necessary to elucidate the specific effects of ACS on the incidence of NEC. 3.2 The impact of ACS use on BPD and hsPDA Under normal pregnancy conditions, the expression of placental 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) increases during early to mid-pregnancy and subsequently decreases in mid to late pregnancy. This enzyme converts endogenous glucocorticoids (GCs) into cortisone, effectively preventing fetal exposure to GCs during the early to mid-pregnancy phases while promoting fetal lung maturation in the later stages of pregnancy [ 14 ] . The results of this study indicate that ACS can significantly reduce the incidence of hsPDA (p = 0.038) and BPD (p = 0.045) in preterm infants. Due to insufficient exposure to glucocorticoids (GCs), preterm infants often exhibit incomplete lung development. The administration of antenatal corticosteroids, such as dexamethasone, enhances fetal lung maturity through placental transfer, inhibits cyclooxygenase, affects prostaglandin synthesis, increases cyclic adenosine monophosphate activity, and reduces prostaglandin E2 receptor sensitivity, thereby promoting the contraction of smooth muscle around the ductus arteriosus. Furthermore, it influences cyclic guanosine monophosphate activity and decreases nitric oxide (NO) receptor sensitivity, facilitating the closure of the ductus arteriosus [ 15 ] . These findings align with the majority of domestic and international research. A retrospective analysis [ 16 ] of preterm infants with GA of less than 32 weeks and hsPDA revealed that the occurrence of hsPDA is significantly associated with factors such as PDA size, GA, BW, and ACS (P < 0.05). Natural conception, ACS, and magnesium sulfate have been shown to be beneficial for the closure of hsPDA. Another study involving 264 neonates indicated that ACS (OR = 0.500, 95% CI: 0.275–0.971) serves as a protective factor against neonatal PDA [ 17 ] . In a study examining the impact of maternal ACS use on the outcomes of extremely preterm infants and their neurodevelopment during infancy [ 18 ] , it was found that among 190 extremely preterm infants, the incidence of neonatal respiratory distress syndrome, BPD, neonatal pneumonia, and neonatal wet lung was significantly lower in the ACS group compared to the non-ACS group (P < 0.008). Additionally, a meta-analysis [ 19 ] that included 424 preterm infants with BPD and 1,024 normal preterm infants during the same period demonstrated that preterm infants with PDA had a higher risk of developing BPD compared to normal preterm infants (OR = 1.49, 95% CI: 1.19–1.85, P < 0.05). The primary exogenous antenatal corticosteroids utilized are betamethasone and dexamethasone. These medications contribute to improved respiratory function in newborns, a reduction in the incidence of diseases among preterm infants, and a decrease in neonatal mortality rates [ 20 ] . 3.3 Multiple factors influence the occurrence and severity of NEC The occurrence and severity of NEC are influenced by multiple factors. Generally, the smaller GA and the lower BW, the more underdeveloped the systems of preterm infants, making them more susceptible to injury during postnatal stress. Our study indicates that different ethnic groups and medical institutions across various regions also affect the severity of NEC. This may be attributed to disparities in medical standards among institutions, resulting in more severe cases of NEC being concentrated in facilities with higher medical standards. In terms of ethnicity, over 90% of the infants in this study were of Han ethnicity, with ethnic minorities representing a smaller proportion. Therefore, to further elucidate the impact of ethnicity on NEC, it is essential to expand the sample size and conduct more in-depth research. Moreover, hsPAD may increase the incidence of NEC, a finding that aligns with the majority of research both domestically and internationally. A meta-analysis [ 21 ] encompassing 38 studies revealed that patent ductus arteriosus (PDA) is a risk factor for NEC in preterm infants (OR = 1.57, P = 0.001). In another meta-analysis [ 22 ] involving 98 randomized controlled trials, it was demonstrated that the use of any probiotics, along with ACS and the combination of ibuprofen and indomethacin for PDA treatment in pregnant women at risk of preterm birth, led to a reduction in the incidence of NEC. This reduction may be attributed to the adverse effects of PDA on the respiratory and circulatory systems of premature infants, where severe left-to-right shunting results in increased pulmonary blood flow, causing interstitial and alveolar edema, reduced lung compliance, and impaired respiratory function. Consequently, this triggers persistent pulmonary hypertension and necessitates prolonged mechanical ventilation to maintain respiratory function [ 17 , 23 ] . Simultaneously, hsPDA diminishes effective systemic circulation [ 24 ] , leading to inadequate perfusion of multiple organs, which results in ischemia and hypoxia. In the gastrointestinal tract, this manifests as damage to the mucosal barrier, leading to bleeding and chronic inflammation, thereby increasing the risk of NEC. The continuous use of a ventilator inevitably results in excessive gas entering the gastrointestinal tract of the infant, further heightening the risk of damage to the gastrointestinal mucosal barrier and exacerbating the severity of NEC. Relevant studies have confirmed that ACS can promote lung maturation in preterm infants [ 25 ] , improve respiratory function, and facilitate the closure of the ductus arteriosus. These findings align with the results of the present study, which indicate that ACS significantly reduces the occurrence of hsPDA (OR = 0.612, CI:0.385–0.974). Therefore, the application of ACS not only diminishes the risk of ventilator dependence and the incidence of hsPDA in preterm infants but also aids in decreasing the incidence and severity of NEC. In this study, we found that the occurrence of intracranial hemorrhage prior to the onset of NEC is associated with the development of NEC. This association may be attributed to the immature nervous system of preterm infants, the underdeveloped subependymal capillaries, and their inability to autonomously regulate cerebral blood flow. Factors such as hypoxia, hypercapnia, high-frequency oscillatory ventilation [ 26 ] , and infections can easily lead to fluctuations in arterial blood pressure, which in turn cause variations in cerebral blood flow, resulting in the rupture of cerebral micro vessels and subsequent hemorrhage. Our findings indicate that infants with stage III NEC had a platelet count of 189.0 (115.0, 318.5) × 10 9 /L, which was lower than that of preterm infants in stages I and II, making them more susceptible to bleeding. Therefore, cranial ultrasound in preterm infants may facilitate the earlier detection of intracranial hemorrhage before gastrointestinal bleeding occurs. Although this study did not definitively demonstrate the impact of ACS on intracranial hemorrhage, some studies have suggested that ACS may reduce the risk of intraventricular hemorrhage in neonates (RR 0.58, 95% CI 0.45–0.75) [ 27 ] . This further suggests that the use of ACS can influence the developmental maturation of various systems in preterm infants and reduce the incidence of preterm-related diseases. In summary , maternal pregnancy complicated by chorioamnionitis, lower GA, reduced BW, and decreased Apgar scores at both 1 and 5 minutes, as well as an earlier onset age, presence of hsPDA after birth, intracranial hemorrhage, reliance on respiratory support methods prior to onset, lower absolute values of white blood cells and platelets, and elevated serum creatinine levels during NEC indicate an increased risk and severity of NEC. The ACS has been shown to mitigate the severity of NEC in preterm infants and to decrease the incidence of hsPDA, BPD, and the need for surgical interventions postnatally. Declarations Supplementary Information Acknowledgments The authors extend gratitude to all the newborns participated in this study for their invaluable contributions, and thank the four collaborating centers for providing and sharing the data. Thank all the newborns who participated in the research for the data and information they provided. Authors’ contributions All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. Chengyu Wang,Cheng Cai， Arigonggaowa Jia Wang, Jinglin Xu,and Fan He made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; Yanbin An, Na Zhuo, Jiexia Gao, Bowen Weng, Jiahuai Liu, Cong Yu, and Dongmei Chen have been involved in drafting the manuscript or revising it critically for important intellectual content;Cheng Cai and Arigonggaowa revised the manuscript and gave final approval of the version to be published. Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors read and approved the final manuscript. Funding This study was supported by grants from 2023 "Science and Technology Rejuvenating Mongolia" Shanghai Jiaotong University Action Plan special project (No.2023XY JG0001-01-09). Ethics approval and consent to participate All methods of this study were reviewed and approved by ethics committee of Shanghai Children’s Hospital in accordance with Declaration of Helsinki and its later amendments (approval number: 2022RY062). All the parents of enrolled patients read and signed the informed consent. Consent for publication Not applicable. Competing interests All authors declare that there is no conflict of interest in this study. Author details Inner Mongolia Medical University, Inner Mongolia, China. Email: [email protected] number：15754894427 Conflicts of interest: The authors declare that they have no conflict of interest. Data availability statement: The datasets used and/or analysed during the current study areavailable from the corresponding author on reasonable request. References Bernardo G D, Ziello C, Parisi G, et al. Clinical Picture, Diagnosis, Management of NEC, and Effects of Probiotics on its Prevention: A Narrative Review[J], 2025, 21(2): 104-110. 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Tables Table 1 Comparison of Baseline Characteristics of 443 Preterm Infants Baseline Characteristics M （ P25~P75 ） /n （ % ） Gestational age (weeks) Gestational age classification Extremely preterm (<28 weeks) Very preterm (28–<32 weeks) Moderately preterm (32–<34 weeks) Late preterm (34–<37 weeks) 32.08±2.98 42（9.48） 173（39.50） 83（18.74） 145（32.73） Birth weight (kg) 1.685±0.573 Sex Male 268（60.50） Female 175（39.50） Ethnicity Han 421（95.03） Mongolian 21 （4.74） Manchu 1（0.23） Region Jiangxi Provincial Children's Hospital 115（25.96） Inner Mongolia Maternity and Child Health Care Hospital 119（26.86） Quanzhou Maternity and Children’s Hospital 105（23.70） Shanghai Children’s Hospital 104（23.48） Mode of delivery Cesarean section 301（67.95） Vaginal delivery 142（32.05） High-risk factors Gestational hypertension 101（22.80） Chorioamnionitis 59（13.32） Placental abruption 31（7.00） Placenta previa 16（3.61） Premature rupture of membranes (h) 39.00（7.50~72.00） ACS 213（48.08） Apgar score 1-minute 9.0（8.0~9.0） 5-minute 9.0（9.0~10.0） Resuscitation at birth Non-invasive ventilation 85（19.19） Invasive ventilation 61（13.77） Invasive ventilation + chest compressions 6（1.35） Age at NEC onset (days) 11.0（5.0~20.0） Gestational age at NEC onset (weeks) 34.43（32.57~36.42） NEC stage Stage I 149（33.63） Stage II 219（49.44） Stage III 75（16.93） Respiratory support at NEC onset Non-invasive ventilation 174（40.56） Invasive ventilation 70（16.23） Full enteral feeding at NEC onset 156（38.42） Feeding type at NEC onset Breast milk 93（22.91） Preterm formula 97（23.89） Partially hydrolyzed formula 24（5.91） Extensively hydrolyzed formula 42（10.34） Mixed feeding 135（33.25） Pre-NEC intracranial hemorrhage 70（19.94） Blood transfusion within 1 week pre-NEC 50（11.93） hsPDA 141（34.99） BPD 87（20.96） Laboratory values at NEC onset White blood cells (×10⁹/L) 9.90（6.78~13.20） Red blood cells (×10¹²/L) 3.78（3.26~4.37） Platelets (×10⁹/L) 279.00（185.50~374.50） Hemoglobin (g/L) 133.00（112.00~154.00） Hematocrit (%) 38.60（32.70~44.78） Peak serum creatinine(Scr) (μmol/L) 33.00(25.00~46.00) Sepsis 169（38.15） Shock 54（12.19） Gastrointestinal perforation 46（10.85） Surgery 96（21.67） Peritoneal drainage 1（1.04） Primary anastomosis 31（32.29） Enterostomy 64（66.67） Hospital stay (days) 35.00（21.00~58.0） Mortality 23（5.19） Table 2 Association Between ACS and NEC Variables ACS n（%）/M（P25~P75） χ 2 /U p No （n=230） Yes （n=213） Region 1. Jiangxi Provincial Children's Hospital 49(21.30) 66(30.99) 20.711 0.000** 2.Inner Mongolia Maternity and Child Health Care Hospital 78(33.91) 41(19.25) 3.Quanzhou Maternity and Children’s Hospital 42(18.26) 63(29.58) 4.Shanghai Children’s Hospital 61(26.52) 43(20.19) Sex (male) 140(60.87) 128(60.09) 0.028 0.867 Ethnicity (Han) 215(93.48) 206(96.71) 2.878 0.237 Gestational age 1. <28 weeks 25(10.87) 17(7.98) 9.401 0.024* 2. 28–<32 weeks 86(37.39) 87(40.85) 3. 32–<34 weeks 33(14.35) 50(23.47) 4. 34–<37 weeks 86(37.39) 59(27.70) Cesarean delivery 159(69.13) 142(66.67) 0.308 0.579 Gestational hypertension 57(24.78) 44(20.66) 1.069 0.301 Chorioamnionitis 24(10.43) 35(16.43) 3.445 0.063 Resuscitation 1. Non-invasive ventilation 50(21.74) 35(16.43) 4.820 0.185 2. Invasive ventilation 36(15.65) 25(11.74) 3. Invasive + chest compressions 2(0.87) 4(1.88) hsPDA 59(26.70) 37(18.23) 4.334 0.037* BPD 53(24.88) 34(16.83) 4.056 0.044* NEC Stage 1.Stage I 62(26.96) 87(40.85) 10.787 0.005** 2. Stage II 121(52.61) 98(46.01) 3. Stage III 47(20.43) 28(13.15) Blood transfusion within 1 week pre-NEC 31(14.09) 19(9.55) 2.052 0.152 Respiratory support at NEC onset 1. Non-invasive ventilation 95(43.58) 79(37.44) 3.464 0.177 2. Invasive ventilation 29(13.30) 41(19.43) Abnormal white matter echogenicity pre-NEC onset 8(4.57) 6(4.41) 0.005 0.946 Ventricular enlargement pre-NEC onset 14(7.73) 11(7.10) 0.049 0.824 Intracranial hemorrhage pre-NEC onset 32(17.39) 38(22.75) 1.577 0.209 Sepsis 85(36.96) 84(39.44) 0.288 0.591 Shock 31(13.48) 23(10.80) 0.742 0.389 Gastrointestinal perforation 28(12.44) 18(9.05) 1.262 0.261 Surgery 59(25.65) 37(17.37) 4.468 0.035* Surgical approach 1. Primary anastomosis 18(30.51) 13(35.14) 0.807 0.668 2. Enterostomy 40(67.80) 24(64.86) Outcome (Survival) 215(93.48) 205(96.24) 1.719 0.190 1-minute Apgar score 9.0 （8.0~9.0） 8.0（8.0~9.0） 23831.00 0.788 5-minute Apgar score 9.0（9.0~10.0） 9.0 （9.0~10.0） 22642.00 0.358 Age at NEC onset (days) 11.0(5.0,20.0) 12.0(6.0,20.0) 23581.50 0.497 Laboratory values at NEC onset White blood cells (×10⁹/L) 10.00(7.0,13.0) 9.85(6.7,13.4) 23977.00 0.824 Red blood cells (×10¹²/L) 268.00 (187.5,366.0) 296.00 (185.0,380.8) 22769.50 0.261 Platelets (×10⁹/L) 3.86(3.2,4.4) 3.70(3.3,4.3) 23619.50 0.567 Hemoglobin (g/L) 136.00 (108.0,155.0) 130.00 (112.5,150.0) 23583.00 0.548 Hematocrit (%) 39.50 (31.1,45.7) 38.20 (33.1,43.9) 23329.00 0.525 Scr (μmol/L) 35.30 (26.0,48.0) 31.00 (23.4,45.0) 15899.50 0.018* Hospital stay (days) 35.00 (20.0,59.3) 36.00 (23.0,55.5) 23757.00 0.584 Table 3 Univariate Regression Analysis of Antenatal Steroid Use on Comorbidities Variables χ 2 p OR 95% CI hsPDA 4.292 0.038 0.612 0.385 ~ 0.974 BPD 4.014 0.045 0.611 0.377 ~ 0.989 Sepsis 0.288 0.591 1.111 0.757 ~ 1.630 Shock 0.739 0.390 0.777 0.437 ~ 1.381 Surgery 4.422 0.035 0.609 0.384 ~ 0.967 Intracranial hemorrhage 1.569 0.210 1.399 0.827 ~ 2.367 White matter abnormalities 0.005 0.946 0.963 0.326 ~ 2.846 ventricular enlargement 0.049 0.824 0.911 0.401 ~ 2.070 Survival outcome 1.678 0.195 0.559 0.232 ~ 1.347 Table 4 Correlation Analysis of Risk Factors by NEC Stage Variables NEC n（%）/M（P25~P75） χ 2 /H p Stage I |（n=149） Stage II （n=219） Stage III （n=75） Region 1. Jiangxi Provincial 13(8.72) 55(25.11) 47(62.67) 98.512 0.000* 2.Inner Mongolia M 64(42.95) 53(24.20) 2(2.67) 3.Quanzhou l 27(18.12) 65(29.68) 13(17.33) 4.Shanghai 45(30.20) 46(21.00) 13(17.33) Sex (male) 88(59.06) 128(58.45) 52(69.33) 2.964 0.227 Gestational age classification 1. <28 weeks 7(4.70) 16(7.31) 19(25.33) 42.655 0.000* 2. 28–<32 weeks 75(50.34) 73(33.33) 25(33.33) 3. 32–<34 weeks 29(19.46) 39(17.81) 15(20.00) 4. 34–<37 weeks 38(25.50) 91(41.55) 16(21.33) Ethnicity (Han 134(89.93) 212(96.80) 75(100.00) 14.117 0.007* Cesarean delivery 106(71.14) 149(68.04) 46(61.33) 2.205 0.332 Gestational hypertension 38(25.50) 53(24.20) 10(13.33) 4.682 0.096 Chorioamnionitis 9(6.04) 28(12.79) 22(29.33) 23.553 0.000* Intrahepatic cholestasis of pregnancy 5(3.36) 6(2.74) 0(0.00) 2.438 0.296 Placental abruption 8(5.37) 17(7.76) 6(8.00) 3.734 0.443 ACS 87(58.39) 98(44.75) 28(37.33) 10.787 0.005* Resuscitation 1. Non-invasive ventilation 30(20.13) 39(17.81) 16(21.33) 7.078 0.314 2. Invasive ventilation 16(10.74) 29(13.24) 16(21.33) 3. Invasive + chest compressions 3(2.01) 3(1.37) 0(0.00) hsPDA 26(17.45) 41(19.71) 29(43.28) 19.612 0.000* BPD 25(16.89) 38(18.54) 24(38.71) 13.994 0.001* Blood transfusion within 1 week pre-NEC 17(11.81) 22(10.28) 11(18.03) 2.718 0.257 Respiratory support at NEC onset 1. Non-invasive ventilation 69(46.31) 79(37.44) 26(37.68) 32.533 0.000* 2. Invasive ventilation 16(10.74) 28(13.27) 26(37.68) Full enteral feeding at NEC onset 43(29.66) 90(43.48) 23(42.59) 7.344 0.025* Feeding type at NEC onset 1. Breast milk 38(26.95) 40(20.00) 15(23.08) 30.539 0.001* 2. Preterm formula 30(21.28) 40(20.00) 27(41.54) 3. Full-term infant milk. 3(2.13) 10(5.00) 2(3.08) 4. Partially hydrolyzed formula 3(2.13) 14(7.00) 7(10.77) 5. Extensively hydrolyzed formula 15(10.64) 21(10.50) 6(9.23) 6. Mixed feeding 52(36.88) 75(37.50) 8(12.31) Abnormal white matter echogenicity 5(3.85) 8(5.48) 1(2.86) 0.675 0.714 Ventricular enlargement 8(6.11) 11(6.75) 6(14.29) 3.309 0.191 Intracranial hemorrhage 32(23.88) 24(13.71) 14(33.33) 10.271 0.006* Sepsis 54(36.24) 65(29.68) 50(66.67) 32.736 0.000* Shock 10(6.71) 16(7.31) 28(37.33) 53.355 0.000* Gastrointestinal perforation 1(0.71) 5(2.40) 40(53.33) 170.285 0.000* Surgery 1(0.67) 31(14.16) 64(85.33) 225.072 0.000* Surgical approach 1. Primary anastomosis 0(0.00) 14(45.16) 17(26.56) 4.141 0.387 2. Enterostomy 1(100.00) 17(54.84) 46(71.88) Outcome (Survival) 145(97.32) 212(96.80) 63(84.00) 21.474 0.000* Birth weight (kg) 1.510 (1.2,1.9) 1.750 (1.3,2.2) 1.500 (1.1,1.9) 12.237 0.002* Gestational age (weeks) 31.71 (30.14,34.0) 33.00 (30.0,35.4) 30.57 (27,33.71) 15.658 0.000* Premature Rupture of Membranes （ h ） 33.000 (7.5,72.0) 44.500 (6.8,72.0) 36.000 (12.0,96.0) 0.182 0.913 1-minute Apgar score. 9.000 (8.0,9.0) 9.000 (8.0,9.0) 8.000 (7.0,9.0) 11.879 0.003* 5-minute Apgar score. 9.000 (9.0,9.0) 9.000 (9.0,10.0) 9.000 (9.0,10.0) 12.909 0.002* Age at NEC onset (days) 14.000 (6.5,22.0) 10.000 (5.0,19.0) 9.000 (4.0,17.0) 10.119 0.006* Laboratory values at NEC onset White blood cells (×10⁹/L) 9.540 (7.3,12.7) 10.400 (7.2,13.3) 8.080 (4.0,13.0) 9.247 0.010* Platelets (×10⁹/L) 287.000 (199.0,368.5) 307.000 (214.0,395.0) 189.000 (115.0,318.5) 29.139 0.000* Red blood cells (×10¹²/L) 3.780 (3.3,4.5) 3.800 (3.3,4.4) 3.705 (3.2,4.2) 2.584 0.275 Hemoglobin (g/L) 133.000 (115.0,159.5) 135.000 (112.0,155.0) 127.000 (102.8,152.0) 3.431 0.180 Hematocrit (%) 39.000 (34.3,44.8) 39.300 (32.5,45.0) 37.500 (30.4,44.4) 1.849 0.397 SCr（μmol/L）） 33.650(26.9,45.0) 30.000(22.0,41.5) 45.000(31.8,57.3) 30.019 0.000* Hospital stay (days) 42.000 (27.0,59.5) 33.000 (20.0,57.0) 26.000 (16.0,61.0) 12.031 0.002* Table 5 Multivariate Regression Analysis of NEC Risk Factors Model 1: Unadjusted Multinomial Logistic Regression Stage II NEC β SE z Wald χ 2 p OR 95% CI ACS -0.550 0.215 -2.560 6.553 0.010 0.577 0.379 ~ 0.879 Stage III NEC β SE z Wald χ 2 p OR 95% CI ACS -0.857 0.291 -2.945 8.674 0.003 0.425 0.240 ~ 0.751 McFadden R² = 0.012 Cox & Snell R² = 0.024 Nagelkerke R² = 0.028 Model 2: Adjusted for GA, Birth Weight, Sex, Ethnicity, and Region Stage II NEC β SE z Wald χ 2 p OR 95% CI Gestational age (weeks) -0.006 0.010 -0.592 0.350 0.554 0.994 0.975 ~ 1.013 Birth weight (kg) 0.669 0.358 1.869 3.492 0.062 1.953 0.968 ~ 3.941 Sex 0.084 0.227 0.370 0.137 0.711 1.088 0.697 ~ 1.697 Ethnicity -1.418 0.485 -2.927 8.565 0.003 0.242 0.094 ~ 0.626 Region -0.253 0.104 -2.433 5.920 0.015 0.777 0.633 ~ 0.952 ACS -0.663 0.225 -2.947 8.683 0.003 0.515 0.332 ~ 0.801 Stage III NEC β SE z Wald χ 2 p OR 95% CI Gestational age (weeks) -0.054 0.015 -3.498 12.233 0.000 0.948 0.920 ~ 0.977 Birth weight (kg) 1.402 0.570 2.460 6.050 0.014 4.063 1.330 ~ 12.414 Sex -0.263 0.329 -0.800 0.639 0.424 0.768 0.403 ~ 1.466 Ethnicity -19.052 3577.859 -0.005 0.000 0.996 0.000 0.000 ~ Infinity Region -0.887 0.155 -5.739 32.937 0.000 0.412 0.304 ~ 0.558 ACS -1.252 0.322 -3.885 15.097 0.000 0.286 0.152 ~ 0.538 McFadden R² = 0.105 Cox & Snell R² = 0.192 Nagelkerke R² = 0.220 Model 3: Adjusted for Multiple Confounders Stage II NEC β SE z Wald χ 2 p OR 95% CI Gestational age (weeks) -0.001 0.011 -0.056 0.003 0.955 0.999 0.977 ~ 1.022 Birth weight (kg) 0.666 0.394 1.691 2.858 0.091 1.947 0.899 ~ 4.215 Sex 0.095 0.238 0.397 0.158 0.691 1.099 0.689 ~ 1.754 Ethnicity -1.336 0.490 -2.724 7.419 0.006 0.263 0.101 ~ 0.688 Region -0.011 0.133 -0.083 0.007 0.934 0.989 0.761 ~ 1.285 ACS -0.583 0.237 -2.458 6.044 0.014 0.558 0.351 ~ 0.889 Chorioamnionitis 0.953 0.561 1.699 2.887 0.089 2.595 0.864 ~ 7.793 Feeding type 0.096 0.058 1.645 2.707 0.100 1.101 0.982 ~ 1.234 hsPDA 0.389 0.342 1.138 1.295 0.255 1.476 0.755 ~ 2.883 Respiratory support at NEC onset 0.125 0.202 0.619 0.383 0.536 1.133 0.763 ~ 1.684 Stage III NEC β SE z Wald χ 2 p OR 95% CI Gestational age (weeks) -0.051 0.021 -2.472 6.111 0.013 0.950 0.912 ~ 0.989 Birth weight (kg) 1.853 0.726 2.552 6.512 0.011 6.380 1.537 ~ 26.482 Sex -0.352 0.385 -0.914 0.835 0.361 0.703 0.331 ~ 1.496 Ethnicity -19.769 5627.988 -0.004 0.000 0.997 0.000 0.000 ~ Infinity Region -0.537 0.201 -2.663 7.092 0.008 0.585 0.394 ~ 0.868 ACS -1.313 0.393 -3.341 11.165 0.001 0.269 0.125 ~ 0.581 Chorioamnionitis 1.614 0.656 2.460 6.052 0.014 5.024 1.388 ~ 18.181 Feeding type -0.101 0.094 -1.070 1.145 0.285 0.904 0.751 ~ 1.088 hsPDA 0.867 0.437 1.985 3.940 0.047 2.381 1.011 ~ 5.607 Respiratory support at NEC onset 0.616 0.309 1.990 3.961 0.047 1.851 1.009 ~ 3.394 McFadden R² = 0.134 Cox & Snell R² = 0.235 Nagelkerke R² = 0.272 Additional Declarations No competing interests reported. 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11:56:00","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":286452,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7698735/v1/9f5597a1b0c4b7334932410f.html"},{"id":96285079,"identity":"cb1cf2cd-198e-47d6-80d0-547a6d31f0d4","added_by":"auto","created_at":"2025-11-19 11:56:00","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":93311,"visible":true,"origin":"","legend":"\u003cp\u003eInclusion Flowchart.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7698735/v1/e8597563dc407e1c6d97b8f9.png"},{"id":99788385,"identity":"bcf75492-4551-497b-888a-fdd8576a31a4","added_by":"auto","created_at":"2026-01-08 12:46:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2910161,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7698735/v1/f3337a22-eb8b-4241-879b-4dbc0b5cf3c0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prenatal Corticosteroid Use Improves the Severity and Complications of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Clinical Study in China","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNecrotizing enterocolitis (NEC) is a severe gastrointestinal disease that occurs during the neonatal period and is a significant cause of neonatal mortality, particularly among preterm infants \u003csup\u003e[1]\u003c/sup\u003e. The incidence of NEC in neonatal intensive care units(NICU) is reported to range from 2% to 5%. With the notable increase in the survival rate of preterm infants, there is a concomitant rise in the incidence of NEC\u003csup\u003e[2]\u003c/sup\u003e. Consequently, early prevention and management of NEC are crucial to reducing mortality and preventing long-term adverse complications in preterm infants. Current research indicates that the occurrence of NEC is influenced by various maternal and neonatal risk factors, including gestational hypertension\u003csup\u003e[3]\u003c/sup\u003e, chorioamnionitis, maternal prenatal antibiotic exposure, intrauterine growth restriction (IUGR), preterm birth, low BW, hypoxia, infection, anemia, and blood transfusion\u003csup\u003e[4-6]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFurthermore, the use of ACS has been shown to mitigate the risk of various complications in preterm infants, such as respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and NEC. However, the relationship between ACS usage and the incidence and severity of NEC is intricate and influenced by numerous factors\u003csup\u003e[2]\u003c/sup\u003e. Therefore, this study aims to analyze the impact of ACS administration on the severity and complications of NEC, with the objective of providing references for the prevention and treatment of this condition.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003e1.1 General Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 443 preterm infants diagnosed with NEC at Stage I or above were included in this study, which was conducted between June 2020 and June 2024 across four centers: Shanghai Children's Hospital, Jiangxi Children's Hospital, Quanzhou Children's Hospital, and Inner Mongolia Maternal and Child Health Hospital. The diagnosis was established using the modified Bell staging criteria\u003csup\u003e[7]\u003c/sup\u003e. The infants were monitored until discharge, transfer, or death, whichever occurred first.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria:\u003c/strong\u003e (1) Bell stage I or above; (2) GA less than 37 weeks;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria:\u003c/strong\u003e (1) Developmental malformations of the digestive tract; (2) Congenital inherited metabolic disorders; (3) Incomplete clinical data.\u003c/p\u003e\n\u003cp\u003eBased on whether they received prenatal corticosteroid treatment, the participants were divided into the exposed group (n=213) and the non-exposed group (n=230).（Figure 1）\u003c/p\u003e\n\u003cp\u003eThis study has been reviewed and approved by the Medical Ethics Committee of Shanghai Children's Hospital (Ethics Approval Number: 2022RY062), and written informed consent has been obtained from the guardians of the pediatric patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2\u0026nbsp;Clinical Indicators\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective analysis was conducted on the clinical data of children who received ACS and those who did not, focusing on extracting potential risk factors and comorbidities that could influence the occurrence and outcomes of NEC, including the following:\u003c/p\u003e\n\u003cp\u003e(1)\u0026nbsp;\u0026nbsp;Maternal conditions during pregnancy: such as gestational hypertension, chorioamnionitis, placental abruption, placenta previa, premature rupture of membranes, etc.\u003c/p\u003e\n\u003cp\u003e(2)\u0026nbsp;\u0026nbsp;General information of the pediatric patient: such as GA at birth, weight, ethnicity, gender, medical institution, duration of hospitalization, and outcome, etc.\u003c/p\u003e\n\u003cp\u003e(3)\u0026nbsp;\u0026nbsp;Postnatal clinical conditions: such as whether resuscitation was performed at birth, Apgar scores at 1 and 5 minutes, NEC grade, age at onset, respiratory support method at onset, whether full enteral feeding was achieved, feeding method at onset and any blood transfusion within one week before the onset of the disease, etc.\u003c/p\u003e\n\u003cp\u003e(4)\u0026nbsp;\u0026nbsp;Comorbid conditions: such as whether there was hsPDA after birth, whether there was intracranial hemorrhage, sepsis, shock, gastrointestinal perforation, surgery, BPD, etc., before the onset of the disease, etc.\u003c/p\u003e\n\u003cp\u003e(5)\u0026nbsp;\u0026nbsp;Laboratory tests: such as white blood cell count, red blood cell count, platelet count, and hemoglobin count at the onset of the disease; hematocrit at the onset of the disease, and the highest serum creatinine level during NEC, etc.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.3\u0026nbsp;Statistical Processing.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData analysis was conducted using SPSS version 27.0. Categorical data are presented as n (%), with intergroup comparisons performed using the χ² test or Fisher's exact test. Normally distributed continuous data are expressed as mean ± standard deviation (x̄ ± s), and intergroup comparisons were conducted using the t-test. For non-normally distributed continuous data, results are presented as M (P25, P75), with intergroup comparisons performed using the Mann-Whitney U test. A P-value of less than 0.05 was deemed statistically significant. Risk factors identified as statistically significant in the univariate analysis were subsequently analyzed using multivariate logistic regression analysis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e2.1 Baseline data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom June 2020 to June 2024, a total of 680 neonates diagnosed with NEC at the Department of neonatology in four hospitals were included in this study. Among them, 443 preterm infants met the inclusion criteria and were enrolled for analysis. The average GA of this cohort was 32.08 ± 2.98 weeks, and the average BW was 1.685 ± 0.573 kg. Of the participants, 268 (60.50%) were male, 21 were of Mongolian descent, and 1 was of Manchu descent, all from the Inner Mongolia Maternity and Child Health Care Hospital, which accounted for 18.49% of the total number of participants enrolled at that institution.There were 101 (22.80%) mothers of the infants who had gestational hypertension, 29 (13.32%) who had chorioamnionitis, and 213 (48.08%) infants who received ACS treatment prenatally.\u003c/p\u003e\n\u003cp\u003eThe median age of onset was 11.0 days, with a P25~P75 range of 5.0 to 20.0 days. \u0026nbsp;Preterm infants with a GA of less than 34 weeks accounted for 48.98% of all patients.\u003c/p\u003e\n\u003cp\u003eAt the onset of NEC, 56.79% of the infants required ventilator-assisted ventilation. Of these, 156 infants (38.42%) achieved full enteral feeding, while only 93 infants were exclusively breastfed, representing 22.91% of the total.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong the total population of infants studied, 87 (20.96%) were diagnosed with bronchopulmonary dysplasia (BPD). Additionally, 34.99% of the infants presented with hemodynamically significant patent ductus arteriosus (hsPDA) shortly after birth. Concurrently, 169 infants were diagnosed with sepsis, representing 38.15% of the total cohort. The advancements in molecular biology have significantly propelled progress in medical research and treatment.\u003c/p\u003e\n\u003cp\u003eA total of 96 children (21.76%) underwent surgery, of which 31 children (32.29% of all surgical cases) received primary intestinal anastomosis, while 66.67% underwent enterostomy. There were 23 deaths, accounting for 5.19% of the cases.\u0026nbsp;The median hospital stay for all preterm infants was 35.0 (21.00-58.00) days.（Table 1）\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2\u0026nbsp;The impact of ACS on the severity of NEC\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the cohort subjected to ACS treatment, a total of 126 children were diagnosed with stage II or higher NEC, representing 59.15% of the exposed group. Among these, 28 children were diagnosed with stage III NEC, accounting for 13.15% of the exposed group. In contrast, the proportions in the non-exposed group were 73.04% and 20.43%, respectively. Therefore, the difference between the exposed and non-exposed groups was statistically significant, with a p-value of 0.005.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3\u0026nbsp;The Impact of ACS on Complications in Preterm Infants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the exposed group, 17.37% of infants underwent surgery, demonstrating a statistically significant difference compared to 25.65% in the non-exposed group (p=0.035). Additionally, significant differences were observed between the two groups regarding medical institutions (p=0.000), GA (p=0.024), the presence of hsPDA after birth (p=0.037), the occurrence of BPD after birth (p=0.044), and peak serum creatinine (SCr) levels during NEC (p=0.018), with all p-values being less than 0.05, indicating statistical significance. This suggests that the use of prenatal steroids significantly influences the severity of NEC, the decision for surgery following NEC diagnosis, as well as the incidence of hsPDA and BPD after birth, and serum creatinine levels during NEC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFurthermore, significant differences in the use of ACS were noted among medical institutions across different regions and GAs. Quanzhou Children's Hospital exhibited the highest ACS usage rate among preterm infants, reaching 60.00%, whereas the Inner Mongolia Maternal and Child Health Hospital reported a relatively low usage rate of only 34.45%. The ACS usage rates at Jiangxi Children's Hospital and Shanghai Children's Hospital were 41.35% and 57.39%, respectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAdditionally, the ACS usage rates for extremely preterm infants (GA \u0026lt;28 weeks) and late preterm infants (GA 34 weeks ≤ \u0026lt;37 weeks) were 40.78% and 40.69%, respectively, while the rates for very preterm infants (GA 28 weeks ≤ \u0026lt;32 weeks) and early preterm infants (GA 32 weeks ≤ \u0026lt;34 weeks) exceeded half, at 50.30% and 60.24%, respectively (Table 2).\u003c/p\u003e\n\u003cp\u003eA univariate logistic regression analysis was conducted to examine the relationship between ACS administration and postnatal complications and outcomes in preterm infants. The results indicated that ACS administration significantly reduced the incidence of several adverse outcomes, including hsPDA (OR = 0.612, 95% CI: 0.385–0.974), BPD (OR = 0.611, 95% CI: 0.377–0.989), and the need for surgical intervention (OR = 0.609, 95% CI: 0.384–0.967). These findings suggest that ACS may play a crucial role in decreasing the incidence of postnatal complications in preterm infants \u0026nbsp; (Table 3)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4\u0026nbsp;NEC risk factors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThrough χ² and non-parametric tests, we conducted a univariate screening of potential risk factors that may influence both the occurrence and severity of NEC. The results indicated that the p-values for various factors, including medical institution (p=0.000), ethnicity (p=0.007), chorioamnionitis (p=0.000), prenatal steroid use (p=0.050), premature rupture of membranes (p=0.038), GA (p=0.000), BW (p=0.002), Apgar scores at 1 minute and 5 minutes (p=0.003 and p=0.002, respectively), age at onset (p=0.006), respiratory support method at onset (p=0.000), achievement of full enteral feeding at onset (p=0.025), feeding method (p=0.001), presence of intracranial hemorrhage before onset (p=0.006), presence of hsPDA after birth (p=0.000), absolute white blood cell count at onset (p=0.010), absolute platelet count at onset (p=0.000), and SCr level during NEC (p=0.000) were all less than 0.05, indicating statistically significant differences. These factors are identified as risk factors influencing the severity of NEC, while sepsis (p=0.000), shock (p=0.000), gastrointestinal perforation (p=0.000), and BPD (p=0.001) are recognized as severe complications associated with NEC (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(1)\u0026nbsp;\u0026nbsp;The postnatal clinical condition influences the severity of NEC.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFurther analysis of the data revealed that the GA and BW for NEC stage III and above were 30.57 (27, 33.71) weeks and 1.5 (1.1, 1.9) kg, respectively. In contrast, for NEC stage II, the values were 33.00 (30.0, 35.42) weeks and 1.75 (1.3, 2.2) kg. Additionally, among infants with NEC stage III and above, the 1-minute Apgar score was 8.0 (7.0, 9.0), which is lower than the scores of 9.0 (8.0, 9.0) for NEC stages I and II. Regarding the age of onset, the median age for Stage I NEC is 14.0 (6.5, 22.0) days, while for Stage II and Stage III NEC, it is 10.0 (5.0, 19.0) days and 9.0 (4.0, 13.0) days, respectively. Therefore, lower GA, lower BW, and lower 1-minute Apgar scores correlate with an earlier age of onset and a greater likelihood of developing NEC, as well as a potential increase in severity. Furthermore, the method of feeding is a significant factor affecting the severity of NEC. The incidence rates of stage II and stage III NEC in breastfed infants are 20.00% and 23.08%, respectively. For those receiving mixed feeding, the rates are 37.50% and 12.31%. In contrast, the rates in preterm infants on artificial feeding are 69.5% and 64.61%, indicating that infants on artificial feeding are at a higher risk of developing NEC and experiencing more severe conditions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(2)\u0026nbsp;\u0026nbsp;Auxiliary examinations can predict the severity of NEC.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLower absolute values of white blood cells and platelets at disease onset, as well as higher peak serum creatinine levels during NEC, indicate greater disease severity. For stage III and above NEC, the median absolute white blood cell count at onset is 8.080 (4.0, 13.0) × 10\u003csup\u003e9\u003c/sup\u003e/L, the median platelet count is 189.000 (115.0, 318.5) × 10\u003csup\u003e9\u003c/sup\u003e/L, and the peak serum creatinine is 45.00 (31.80, 57.30) μmol/L. Furthermore, higher stages of NEC are associated with an increased likelihood of intracranial hemorrhage detected by cranial ultrasound prior to disease onset.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(3)\u0026nbsp;\u0026nbsp;Results of Multivariate Logistic Regression Analysis.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThrough univariate analysis, statistically significant factors influencing both the occurrence and severity of NEC were identified. Subsequently, multivariate logistic regression models were utilized to conduct a comprehensive regression analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea)\u0026nbsp; \u0026nbsp;ACS univariate regression analysis.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the univariate regression model, when comparing suspected (Stage I) NEC to Stage II NEC, the regression coefficient for ACS was -0.550, which was statistically significant at the 0.05 level (z = -2.560, p = 0.010 \u0026lt; 0.05). This corresponds to an odds ratio (OR) of 0.577, indicating that for each unit increase in ACS, the risk of developing Stage II NEC decreases by a factor of 0.577. Similarly, for Stage III NEC, the OR for ACS was 0.425, with a 95% confidence interval (CI) ranging from 0.240 to 0.751. These findings further illustrate that ACS acts as a protective factor against the occurrence and severity of NEC, thereby reducing both the risk of developing NEC and its severity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb)\u0026nbsp; \u0026nbsp;Regression analysis adjusted for GA, BW, sex, and regional confounding factors.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhen adjusting solely for GA, BW, sex, and region, the analysis reveals that, in comparison to stage I NEC, certain factors in stage II NEC exert a negative influence on its occurrence. Specifically, ethnicity ( OR = 0.242, CI: 0.094–0.626), healthcare institution (OR = 0.777, CI: 0.633–0.952), and the application of ACS (OR = 0.515, CI: 0.332–0.801) are identified as significant negative predictors. Furthermore, in the context of stage III NEC, GA (OR = 0.948, CI: 0.920–0.977), the type of medical institution (OR = 0.412, CI: 0.304–0.558), and ACS (OR = 0.286, CI: 0.152–0.538) are all associated with a decreased likelihood of developing stage III NEC and beyond.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec)\u0026nbsp; \u0026nbsp;Regression analysis adjusting for confounding factors including chorioamnionitis, presence of hsPDA after birth, feeding methods before onset, and respiratory support methods.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter adjusting for GA, BW, gender, and region, further regression analysis was conducted by additionally accounting for the presence of chorioamnionitis, postnatal hsPDA, feeding methods prior to the onset of symptoms, and respiratory support methods prior to the onset of symptoms. The results indicated that chorioamnionitis (OR=5.024, CI: 1.388–18.181), hsPDA (OR=2.381, CI: 1.011–5.607), and respiratory support methods prior to symptom onset (OR=1.851, CI: 1.009–3.394) positively influenced the severity of NEC. This suggests that for each unit increase in these three factors, the risk of NEC severity increases by 5.024 times, 2.381 times, and 1.851 times, respectively. Conversely, ACS (OR=0.269, CI: 0.125–0.581) remains a protective factor against the severity of NEC (Table 5).\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this multicenter retrospective study, we found that ACS could ameliorate the severity of NEC and reduce the risk of complications such as BPD and hsPDA. Additionally, factors such as GA, age at onset, white blood cell count, platelet count, serum creatinine levels, and the occurrence of intracranial hemorrhage were identified as significant predictors of NEC severity.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.1 The impact of ACS on the severity of NEC\u003c/h2\u003e\u003cp\u003eThe results of this study indicate that, after adjusting for multiple confounding factors, ACS (OR\u0026thinsp;=\u0026thinsp;0.269, CI: 0.125\u0026ndash;0.581) is a protective factor against the occurrence and severity of NEC. This study demonstrates that ACS enhances lung maturity and reduces intestinal inflammation. ACS exerts protective effects by promoting the maturation of intestinal epithelial cells, enhancing mucus secretion, regulating the intestinal microbiota, and modulating immune responses, such as reducing Toll-like receptor 4 (TLR4) signaling pathway activation, which aids in intestinal development and microbial colonization\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. These findings are corroborated by relevant studies both domestically and internationally. For instance, among 16,338 very low BW infants registered in the Korean Neonatal Network, ACS significantly reduces the risk of NEC requiring surgery\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. A Japanese neonatal study\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e revealed that in preterm infants with GA of less than 32 weeks and BW under 1500g, ACS treatment significantly reduced the risk of mortality (OR\u0026thinsp;=\u0026thinsp;0.61; 95% CI 0.53\u0026ndash;0.70), respiratory distress syndrome (OR\u0026thinsp;=\u0026thinsp;0.71; 95% CI 0.67\u0026ndash;0.76), cerebral palsy (OR\u0026thinsp;=\u0026thinsp;0.85; 95% CI 0.72\u0026ndash;0.99), and NEC (P\u0026thinsp;=\u0026thinsp;0.04). However, the study also indicated that the timing of ACS administration is crucial. The optimal effect of ACS can be observed when administered within 7 days prior to preterm birth, a timing that maximizes its benefits on neonatal outcomes. Both the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG) recommend a single course of antenatal corticosteroids for pregnant women at risk of preterm birth between 24 and 34 weeks of gestation\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHowever, some studies indicate that the relationship between ACS use and NEC is not entirely straightforward. In certain instances, ACS administration may not influence the incidence of NEC, and multiple courses or high doses of steroid hormones could potentially elevate the risk of NEC\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. A study involving infants with GA between 34 and 37 weeks revealed that following ACS administration, the overall respiratory morbidity in newborns decreased (16% vs. 28%, p\u0026thinsp;=\u0026thinsp;0.04). Nevertheless, no significant differences were observed in the incidence of NEC, hypoglycemia, intraventricular hemorrhage, sepsis, and mortality (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05)\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eOur study did not conduct a statistical analysis regarding the dosage and timing of ACS; therefore, further research is necessary to elucidate the specific effects of ACS on the incidence of NEC.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.2 The impact of ACS use on BPD and hsPDA\u003c/h2\u003e\u003cp\u003eUnder normal pregnancy conditions, the expression of placental 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) increases during early to mid-pregnancy and subsequently decreases in mid to late pregnancy. This enzyme converts endogenous glucocorticoids (GCs) into cortisone, effectively preventing fetal exposure to GCs during the early to mid-pregnancy phases while promoting fetal lung maturation in the later stages of pregnancy\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe results of this study indicate that ACS can significantly reduce the incidence of hsPDA (p\u0026thinsp;=\u0026thinsp;0.038) and BPD (p\u0026thinsp;=\u0026thinsp;0.045) in preterm infants. Due to insufficient exposure to glucocorticoids (GCs), preterm infants often exhibit incomplete lung development. The administration of antenatal corticosteroids, such as dexamethasone, enhances fetal lung maturity through placental transfer, inhibits cyclooxygenase, affects prostaglandin synthesis, increases cyclic adenosine monophosphate activity, and reduces prostaglandin E2 receptor sensitivity, thereby promoting the contraction of smooth muscle around the ductus arteriosus. Furthermore, it influences cyclic guanosine monophosphate activity and decreases nitric oxide (NO) receptor sensitivity, facilitating the closure of the ductus arteriosus\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. These findings align with the majority of domestic and international research. A retrospective analysis \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003eof preterm infants with GA of less than 32 weeks and hsPDA revealed that the occurrence of hsPDA is significantly associated with factors such as PDA size, GA, BW, and ACS (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Natural conception, ACS, and magnesium sulfate have been shown to be beneficial for the closure of hsPDA. Another study involving 264 neonates indicated that ACS (OR\u0026thinsp;=\u0026thinsp;0.500, 95% CI: 0.275\u0026ndash;0.971) serves as a protective factor against neonatal PDA \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. In a study examining the impact of maternal ACS use on the outcomes of extremely preterm infants and their neurodevelopment during infancy\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e, it was found that among 190 extremely preterm infants, the incidence of neonatal respiratory distress syndrome, BPD, neonatal pneumonia, and neonatal wet lung was significantly lower in the ACS group compared to the non-ACS group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.008). Additionally, a meta-analysis \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003ethat included 424 preterm infants with BPD and 1,024 normal preterm infants during the same period demonstrated that preterm infants with PDA had a higher risk of developing BPD compared to normal preterm infants (OR\u0026thinsp;=\u0026thinsp;1.49, 95% CI: 1.19\u0026ndash;1.85, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eThe primary exogenous antenatal corticosteroids utilized are betamethasone and dexamethasone. These medications contribute to improved respiratory function in newborns, a reduction in the incidence of diseases among preterm infants, and a decrease in neonatal mortality rates\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Multiple factors influence the occurrence and severity of NEC\u003c/h2\u003e\u003cp\u003eThe occurrence and severity of NEC are influenced by multiple factors. Generally, the smaller GA and the lower BW, the more underdeveloped the systems of preterm infants, making them more susceptible to injury during postnatal stress. Our study indicates that different ethnic groups and medical institutions across various regions also affect the severity of NEC. This may be attributed to disparities in medical standards among institutions, resulting in more severe cases of NEC being concentrated in facilities with higher medical standards. In terms of ethnicity, over 90% of the infants in this study were of Han ethnicity, with ethnic minorities representing a smaller proportion. Therefore, to further elucidate the impact of ethnicity on NEC, it is essential to expand the sample size and conduct more in-depth research.\u003c/p\u003e\u003cp\u003eMoreover, hsPAD may increase the incidence of NEC, a finding that aligns with the majority of research both domestically and internationally. A meta-analysis \u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003eencompassing 38 studies revealed that patent ductus arteriosus (PDA) is a risk factor for NEC in preterm infants (OR\u0026thinsp;=\u0026thinsp;1.57, P\u0026thinsp;=\u0026thinsp;0.001). In another meta-analysis\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e involving 98 randomized controlled trials, it was demonstrated that the use of any probiotics, along with ACS and the combination of ibuprofen and indomethacin for PDA treatment in pregnant women at risk of preterm birth, led to a reduction in the incidence of NEC. This reduction may be attributed to the adverse effects of PDA on the respiratory and circulatory systems of premature infants, where severe left-to-right shunting results in increased pulmonary blood flow, causing interstitial and alveolar edema, reduced lung compliance, and impaired respiratory function. Consequently, this triggers persistent pulmonary hypertension and necessitates prolonged mechanical ventilation to maintain respiratory function\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. Simultaneously, hsPDA diminishes effective systemic circulation\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e, leading to inadequate perfusion of multiple organs, which results in ischemia and hypoxia. In the gastrointestinal tract, this manifests as damage to the mucosal barrier, leading to bleeding and chronic inflammation, thereby increasing the risk of NEC. The continuous use of a ventilator inevitably results in excessive gas entering the gastrointestinal tract of the infant, further heightening the risk of damage to the gastrointestinal mucosal barrier and exacerbating the severity of NEC.\u003c/p\u003e\u003cp\u003eRelevant studies have confirmed that ACS can promote lung maturation in preterm infants\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e, improve respiratory function, and facilitate the closure of the ductus arteriosus. These findings align with the results of the present study, which indicate that ACS significantly reduces the occurrence of hsPDA (OR\u0026thinsp;=\u0026thinsp;0.612, CI:0.385\u0026ndash;0.974). Therefore, the application of ACS not only diminishes the risk of ventilator dependence and the incidence of hsPDA in preterm infants but also aids in decreasing the incidence and severity of NEC.\u003c/p\u003e\u003cp\u003eIn this study, we found that the occurrence of intracranial hemorrhage prior to the onset of NEC is associated with the development of NEC. This association may be attributed to the immature nervous system of preterm infants, the underdeveloped subependymal capillaries, and their inability to autonomously regulate cerebral blood flow. Factors such as hypoxia, hypercapnia, high-frequency oscillatory ventilation\u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e, and infections can easily lead to fluctuations in arterial blood pressure, which in turn cause variations in cerebral blood flow, resulting in the rupture of cerebral micro vessels and subsequent hemorrhage. Our findings indicate that infants with stage III NEC had a platelet count of 189.0 (115.0, 318.5) \u0026times; 10\u003csup\u003e9\u003c/sup\u003e/L, which was lower than that of preterm infants in stages I and II, making them more susceptible to bleeding. Therefore, cranial ultrasound in preterm infants may facilitate the earlier detection of intracranial hemorrhage before gastrointestinal bleeding occurs. Although this study did not definitively demonstrate the impact of ACS on intracranial hemorrhage, some studies have suggested that ACS may reduce the risk of intraventricular hemorrhage in neonates (RR 0.58, 95% CI 0.45\u0026ndash;0.75)\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e. This further suggests that the use of ACS can influence the developmental maturation of various systems in preterm infants and reduce the incidence of preterm-related diseases.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIn summary\u003c/b\u003e, maternal pregnancy complicated by chorioamnionitis, lower GA, reduced BW, and decreased Apgar scores at both 1 and 5 minutes, as well as an earlier onset age, presence of hsPDA after birth, intracranial hemorrhage, reliance on respiratory support methods prior to onset, lower absolute values of white blood cells and platelets, and elevated serum creatinine levels during NEC indicate an increased risk and severity of NEC. The ACS has been shown to mitigate the severity of NEC in preterm infants and to decrease the incidence of hsPDA, BPD, and the need for surgical interventions postnatally.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eSupplementary Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors extend gratitude to all the newborns participated in this study for their invaluable contributions, and thank the four collaborating centers for providing and sharing the data. Thank all the newborns who participated in the research for the data and information they provided.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.\u0026nbsp;Chengyu Wang,Cheng Cai，\u0026nbsp;Arigonggaowa\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Jia Wang, Jinglin Xu,and Fan He made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; Yanbin An, Na Zhuo, Jiexia Gao, Bowen Weng, Jiahuai Liu, Cong Yu, and Dongmei Chen have been involved in drafting the manuscript or revising it critically for important intellectual content;Cheng Cai and Arigonggaowa\u003c/p\u003e\n\u003cp\u003erevised the manuscript and gave final approval of the version to be published. Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by grants from 2023 \u0026quot;Science and Technology Rejuvenating Mongolia\u0026quot; Shanghai Jiaotong University Action Plan special project (No.2023XY JG0001-01-09).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll methods of this study were reviewed and approved by ethics committee of Shanghai Children\u0026rsquo;s Hospital in accordance with Declaration of Helsinki and its later amendments (approval number: 2022RY062). All the parents of enrolled patients read and signed the informed consent.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare that there is no conflict of interest in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInner Mongolia Medical University, Inner Mongolia, China.\u003c/p\u003e\n\u003cp\u003eEmail: [email protected] number：15754894427\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement:\u0026nbsp;\u003c/strong\u003eThe datasets used and/or analysed during the current study areavailable from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBernardo G D, Ziello C, Parisi G, et al. Clinical Picture, Diagnosis, Management of NEC, and Effects of Probiotics on its Prevention: A Narrative Review[J], 2025, 21(2): 104-110.\u003c/li\u003e\n\u003cli\u003eAbebe M, Ayehu M, Tebeje T M, et al. Risk factors of necrotizing enterocolitis among neonates admitted to the neonatal intensive care unit at the selected public hospitals in southern Ethiopia, 2023[J], 2024, 12: 1326765.\u003c/li\u003e\n\u003cli\u003eChen S-N, Wang P-H, Hsieh M-F, et al. Maternal pregnancy-induced hypertension increases the subsequent risk of neonatal candidiasis: A nationwide population-based cohort study[J], 2019, 58(2): 261-265.\u003c/li\u003e\n\u003cli\u003eJa\u0026scaron;ić M, \u0026Scaron;tifter S, Dessardo N S, et al. The relationship between histologic chorioamnionitis and decidual macrophage polarization and their influence on outcomes of neonates born before the 32nd gestational week[J], 2021, 34(10): 1535-1544.\u003c/li\u003e\n\u003cli\u003eGitau K, Ochieng R, Limbe M, et al. The incidence and modifiable risk factors for necrotizing enterocolitis in preterm infants: a retrospective cohort study[J], 2023, 36(2): 2253351.\u003c/li\u003e\n\u003cli\u003eWilliam T P, Christopher S H, William Quintero P, et al. Antepartum Risk Factors for Neonatal Necrotizing Enterocolitis and Bowel Perforations[J]. American Journal of Obstetrics and Gynecology, 2024, 230(2): 615.\u003c/li\u003e\n\u003cli\u003ePace D, Mack S J, Chan S, et al. Antimicrobial Stewardship in Neonates with Necrotizing Enterocolitis: A Quality Improvement Initiative[J], 2023, 58(10): 1982-1989.\u003c/li\u003e\n\u003cli\u003eDong Z, Yin X, Xu D, et al. Advancing necrotizing enterocolitis prediction through iterative monitoring[J], 2024, 13(5): 770-783.\u003c/li\u003e\n\u003cli\[email protected] S F M-F M E A, Hamm R F, Combs C A, et al. Society for Maternal-Fetal Medicine Special Statement: Quality metrics for optimal timing of antenatal corticosteroid administration[J], 2022, 226(6): B2-B10.\u003c/li\u003e\n\u003cli\u003eKim S H, Son J, Research H-K P J P. Surgical necrotizing enterocolitis risk factors in extremely preterm infants: a Korean nationwide cohort study[J], 2024.\u003c/li\u003e\n\u003cli\u003eSocha P, Mcgee A, Bhattacharya S, et al. Antenatal Corticosteroids and Neonatal Outcomes in Twins: A Systematic Review and Meta-analysis[J], 2022, 140(1): 20-30.\u003c/li\u003e\n\u003cli\u003eGulersen M, Grunebaum A, Lenchner E, et al. Antenatal corticosteroids and neonatal outcomes in preterm birth in the United States[J], 2022, 50(5): 573-580.\u003c/li\u003e\n\u003cli\u003eUpadhya R, Bhavana S, Pai M V, et al. Elucidating the Effect of Antenatal Corticosteroids in the Late Preterm Period[J], 2023, 73(2): 107-112.\u003c/li\u003e\n\u003cli\u003eZhou C, Ye F, Wu H, et al. Recent advances in the study of 11\u0026beta;-Hydroxysteroid dehydrogenase type 2 (11\u0026beta;-HSD2)Inhibitors[J], 2017, 52: 47-53.\u003c/li\u003e\n\u003cli\u003eBehbodi E, Villamor-Mart\u0026iacute;nez E, Degraeuwe P L J, et al. Chorioamnionitis appears not to be a Risk Factor for Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis[J], 2016, 6: 37967.\u003c/li\u003e\n\u003cli\u003ePediatrics F O J F I. Molecular and Mechanical Mechanisms Regulating Ductus Arteriosus Closure in Preterm Infants[J], 2020, 8: 516.\u003c/li\u003e\n\u003cli\u003eLiu Y, Qiao L, Wu X, et al. Predictive factors for the surgical treatment of necrotizing enterocolitis in preterm infants: a single-center retrospective study[J], 2022, 22(1): 9.\u003c/li\u003e\n\u003cli\u003eNinan K, Liyanage S K, Murphy K E, et al. Evaluation of Long-term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids: A Systematic Review and Meta-analysis[J], 2022, 176(6): e220483.\u003c/li\u003e\n\u003cli\u003eVillamor E, Westering-Kroon E V, Gonzalez-Luis G E, et al. Patent Ductus Arteriosus and Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Bayesian Meta-Analysis[J], 2023, 6(11): e2345299.\u003c/li\u003e\n\u003cli\u003eNinan K, Gojic A, Wang Y, et al. The proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes: systematic review and meta-analysis of 1.6 million infants[J], 2023, 382: e076035.\u003c/li\u003e\n\u003cli\u003eLu C-Y, Liu K-F, Qiao G-X, et al. Risk factors for necrotizing enterocolitis in preterm infants: a Meta analysis[J], 2022, 24(8): 908-916.\u003c/li\u003e\n\u003cli\u003eXiong T, Maheshwari A, Neu J, et al. An Overview of Systematic Reviews of Randomized-Controlled Trials for Preventing Necrotizing Enterocolitis in Preterm Infants[J], 2020, 117(1): 46-56.\u003c/li\u003e\n\u003cli\u003eChesi E, Rossi K, Ancora G, et al. Patent ductus arteriosus (also non-hemodynamically significant) correlates with poor outcomes in very low birth weight infants. A multicenter cohort study[J], 2024, 19(7): e0306769.\u003c/li\u003e\n\u003cli\u003eCambonie G, Roz\u0026eacute; J-C, Marchand-Martin L, et al. Neurodevelopment at 5 Years of Age According to Early Screening for Patent Ductus Arteriosus in Extremely Preterm Infants[J], 2022, 328(1): 71-73.\u003c/li\u003e\n\u003cli\u003eGould J B, Bennett M V, Phibbs C S, et al. Population Improvement Bias Observed in Estimates of the Impact of Antenatal Steroids to Outcomes in Preterm Birth[J], 2021, 232: 17-22.e2.\u003c/li\u003e\n\u003cli\u003ePerinatology J M P J S I. Periventricular- intraventricular hemorrhage in the premature infant- A historical perspective[J], 2022, 46(5): 151591.\u003c/li\u003e\n\u003cli\u003eMcgoldrick E, Stewart F, Parker R, et al. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth[J], 2020, 12: CD004454.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1 Comparison of Baseline Characteristics of 443 Preterm Infants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBaseline Characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eP25~P75\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003cstrong\u003e/n\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age classification\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Extremely preterm (\u0026lt;28 weeks)\u003c/p\u003e\n \u003cp\u003eVery preterm (28\u0026ndash;\u0026lt;32 weeks)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Moderately preterm (32\u0026ndash;\u0026lt;34 weeks)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Late preterm (34\u0026ndash;\u0026lt;37 weeks)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32.08\u0026plusmn;2.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e42（9.48）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e173（39.50）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e83（18.74）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e145（32.73）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1.685\u0026plusmn;0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e268（60.50）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e175（39.50）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Han\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e421（95.03）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Mongolian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e21 （4.74）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Manchu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1（0.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Jiangxi Provincial Children\u0026apos;s Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e115（25.96）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Inner Mongolia Maternity and Child Health Care Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e119（26.86）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eQuanzhou Maternity and Children\u0026rsquo;s Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e105（23.70）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eShanghai Children\u0026rsquo;s Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e104（23.48）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Cesarean section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e301（67.95）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Vaginal delivery\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e142（32.05）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHigh-risk factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Gestational hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e101（22.80）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Chorioamnionitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e59（13.32）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Placental abruption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e31（7.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Placenta previa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e16（3.61）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Premature rupture of membranes (h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e39.00（7.50~72.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e213（48.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eApgar score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e1-minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e9.0（8.0~9.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e5-minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e9.0（9.0~10.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResuscitation at birth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Non-invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e85（19.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Invasive ventilation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e61（13.77）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Invasive ventilation + chest compressions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e6（1.35）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at NEC onset (days)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e11.0（5.0~20.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age at NEC onset (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e34.43（32.57~36.42）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNEC stage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eStage I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e149（33.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Stage II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e219（49.44）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Stage III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e75（16.93）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory support at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Non-invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e174（40.56）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e70（16.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFull enteral feeding at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e156（38.42）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFeeding type at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Breast milk\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e93（22.91）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Preterm formula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e97（23.89）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Partially hydrolyzed formula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e24（5.91）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Extensively hydrolyzed formula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e42（10.34）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Mixed feeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e135（33.25）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-NEC intracranial hemorrhage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e70（19.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood transfusion within 1 week pre-NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e50（11.93）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ehsPDA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e141（34.99）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBPD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e87（20.96）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaboratory values at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eWhite blood cells (\u0026times;10⁹/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e9.90（6.78~13.20）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eRed blood cells (\u0026times;10\u0026sup1;\u0026sup2;/L)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e3.78（3.26~4.37）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003ePlatelets (\u0026times;10⁹/L)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e279.00（185.50~374.50）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHemoglobin (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e133.00（112.00~154.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHematocrit (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e38.60（32.70~44.78）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003ePeak serum creatinine(Scr) (\u0026mu;mol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e33.00(25.00~46.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSepsis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e169（38.15）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShock\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e54（12.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastrointestinal perforation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e46（10.85）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e96（21.67）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Peritoneal drainage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e1（1.04）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Primary anastomosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e31（32.29）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Enterostomy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e64（66.67）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHospital stay (days)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e35.00（21.00~58.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMortality\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e23（5.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Association Between ACS and NEC\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"584\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en（%）/M（P25~P75）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e/U\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e（n=230）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e（n=213）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e1. Jiangxi Provincial Children\u0026apos;s Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e49(21.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e66(30.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 71px;\"\u003e\n \u003cp\u003e20.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.000**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp;2.Inner Mongolia Maternity and Child Health Care Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e78(33.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e41(19.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.Quanzhou Maternity and Children\u0026rsquo;s Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e42(18.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e63(29.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e4.Shanghai Children\u0026rsquo;s Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e61(26.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e43(20.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex (male)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e140(60.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e128(60.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.867\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity (Han)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e215(93.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e206(96.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e2.878\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e1.\u0026nbsp;\u0026lt;28 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e25(10.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e17(7.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 71px;\"\u003e\n \u003cp\u003e9.401\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.024*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;2. 28\u0026ndash;\u0026lt;32 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e86(37.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e87(40.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;3. 32\u0026ndash;\u0026lt;34 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e33(14.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e50(23.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;4. 34\u0026ndash;\u0026lt;37 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e86(37.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e59(27.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCesarean delivery\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e159(69.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e142(66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.579\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational hypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e57(24.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e44(20.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.301\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChorioamnionitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e24(10.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e35(16.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e3.445\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Resuscitation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e1. Non-invasive ventilation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e50(21.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e35(16.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 71px;\"\u003e\n \u003cp\u003e4.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;2. Invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e36(15.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e25(11.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;3. Invasive + chest compressions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e2(0.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e4(1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ehsPDA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e59(26.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e37(18.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4.334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.037*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBPD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e53(24.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e34(16.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.044*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNEC Stage\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.Stage I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e62(26.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e87(40.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 71px;\"\u003e\n \u003cp\u003e10.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.005**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e2.\u0026nbsp;Stage II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e121(52.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e98(46.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e3.\u0026nbsp;Stage III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e47(20.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e28(13.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood transfusion within 1 week pre-NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e31(14.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e19(9.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e2.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory support at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e1.\u0026nbsp;Non-invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e95(43.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e79(37.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 71px;\"\u003e\n \u003cp\u003e3.464\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e2.\u0026nbsp;Invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e29(13.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e41(19.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbnormal white matter echogenicity pre-NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e8(4.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e6(4.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.946\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVentricular enlargement pre-NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e14(7.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e11(7.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntracranial hemorrhage pre-NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e32(17.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e38(22.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1.577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSepsis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e85(36.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e84(39.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.591\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShock\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e31(13.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e23(10.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.742\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.389\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastrointestinal perforation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e28(12.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e18(9.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1.262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e59(25.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e37(17.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4.468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.035*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgical approach\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e1. Primary anastomosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e18(30.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e13(35.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.807\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.668\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;2. Enterostomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e40(67.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e24(64.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome (Survival)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e215(93.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e205(96.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1.719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003e1-minute Apgar score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003cp\u003e（8.0~9.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e8.0（8.0~9.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23831.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.788\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003e5-minute Apgar score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e9.0（9.0~10.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003cp\u003e（9.0~10.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e22642.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.358\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at NEC onset (days)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e11.0(5.0,20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e12.0(6.0,20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23581.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.497\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaboratory values at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003eWhite blood cells (\u0026times;10⁹/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e10.00(7.0,13.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e9.85(6.7,13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23977.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003eRed blood cells (\u0026times;10\u0026sup1;\u0026sup2;/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e268.00\u003c/p\u003e\n \u003cp\u003e(187.5,366.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e296.00\u003c/p\u003e\n \u003cp\u003e(185.0,380.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e22769.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003ePlatelets (\u0026times;10⁹/L)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e3.86(3.2,4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e3.70(3.3,4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23619.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.567\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003eHemoglobin (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e136.00\u003c/p\u003e\n \u003cp\u003e(108.0,155.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e130.00\u003c/p\u003e\n \u003cp\u003e(112.5,150.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23583.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.548\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003eHematocrit (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e39.50\u003c/p\u003e\n \u003cp\u003e(31.1,45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e38.20\u003c/p\u003e\n \u003cp\u003e(33.1,43.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23329.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.525\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003eScr (\u0026mu;mol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e35.30\u003c/p\u003e\n \u003cp\u003e(26.0,48.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e31.00\u003c/p\u003e\n \u003cp\u003e(23.4,45.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e15899.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.018*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHospital stay (days)\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e35.00\u003c/p\u003e\n \u003cp\u003e(20.0,59.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e36.00\u003c/p\u003e\n \u003cp\u003e(23.0,55.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23757.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.584\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eTable 3 Univariate Regression Analysis of Antenatal Steroid Use on Comorbidities\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003ehsPDA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e4.292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.385 ~ 0.974\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eBPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e4.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.611\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.377 ~ 0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eSepsis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e1.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.757 ~ 1.630\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eShock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.739\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.390\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.777\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.437 ~ 1.381\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eSurgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e4.422\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.609\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.384 ~ 0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eIntracranial hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1.569\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e1.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.827 ~ 2.367\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eWhite matter abnormalities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.946\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.326 ~ 2.846\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eventricular enlargement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.911\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.401 ~ 2.070\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003eSurvival outcome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1.678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0.559\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.232 ~ 1.347\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 Correlation Analysis of Risk Factors by NEC Stage\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"568\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 254px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNEC\u0026nbsp;\u003c/strong\u003en（%）/M（P25~P75）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026chi;\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e/H\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStage I\u003c/strong\u003e |（n=149）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStage II\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e（n=219）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStage III\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e（n=75）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e1. Jiangxi Provincial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e13(8.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e55(25.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e47(62.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e98.512\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp; 2.Inner Mongolia M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e64(42.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e53(24.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e2(2.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp; 3.Quanzhou l\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e27(18.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e65(29.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e13(17.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e4.Shanghai\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e45(30.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e46(21.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e13(17.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex (male)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e88(59.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e128(58.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e52(69.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e2.964\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age classification\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1. \u0026lt;28 weeks\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e7(4.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e16(7.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e19(25.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e42.655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e2. 28\u0026ndash;\u0026lt;32 weeks\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e75(50.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e73(33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e25(33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp; 3. 32\u0026ndash;\u0026lt;34 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e29(19.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e39(17.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e15(20.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp; 4. 34\u0026ndash;\u0026lt;37 weeks\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e38(25.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e91(41.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e16(21.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity (Han\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e134(89.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e212(96.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e75(100.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e14.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.007*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCesarean delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e106(71.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e149(68.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e46(61.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e2.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.332\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational hypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e38(25.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e53(24.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e10(13.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e4.682\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChorioamnionitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e9(6.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e28(12.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e22(29.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e23.553\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntrahepatic cholestasis of pregnancy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e5(3.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e6(2.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e2.438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlacental abruption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e8(5.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e17(7.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e6(8.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e3.734\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.443\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e87(58.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e98(44.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e28(37.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e10.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.005*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResuscitation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e1. Non-invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e30(20.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e39(17.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e16(21.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e7.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.314\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e2. Invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e16(10.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e29(13.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e16(21.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e3. Invasive + chest compressions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e3(2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e3(1.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003ehsPDA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e26(17.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e41(19.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e29(43.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e19.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eBPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e25(16.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e38(18.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e24(38.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e13.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood transfusion within 1 week pre-NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e17(11.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e22(10.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e11(18.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e2.718\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory support at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e1.\u0026nbsp;Non-invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e69(46.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e79(37.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e26(37.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e32.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e2.\u0026nbsp;Invasive ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e16(10.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e28(13.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e26(37.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFull enteral feeding at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e43(29.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e90(43.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e23(42.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e7.344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.025*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFeeding type at NEC onset\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e1. Breast milk\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e38(26.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e40(20.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e15(23.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e30.539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e2.\u0026nbsp;Preterm formula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e30(21.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e40(20.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e27(41.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e3. Full-term infant milk.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e3(2.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e10(5.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e2(3.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e4. Partially hydrolyzed formula\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e3(2.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e14(7.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e7(10.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e5.\u0026nbsp;Extensively hydrolyzed formula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e15(10.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e21(10.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e6(9.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e6.\u0026nbsp;Mixed feeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e52(36.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e75(37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e8(12.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbnormal white matter echogenicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e5(3.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e8(5.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e1(2.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e0.675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVentricular enlargement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e8(6.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e11(6.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e6(14.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e3.309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntracranial hemorrhage\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e32(23.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e24(13.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e14(33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e10.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.006*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSepsis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e54(36.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e65(29.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e50(66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e32.736\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShock\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e10(6.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e16(7.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e28(37.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e53.355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastrointestinal perforation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e1(0.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e5(2.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e40(53.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e170.285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e1(0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e31(14.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e64(85.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e225.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgical approach\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e1. Primary anastomosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e14(45.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e17(26.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e4.141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.387\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e2. Enterostomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e1(100.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e17(54.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e46(71.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome (Survival)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e145(97.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e212(96.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e63(84.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e21.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (kg)\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e1.510\u003c/p\u003e\n \u003cp\u003e(1.2,1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e1.750\u003c/p\u003e\n \u003cp\u003e(1.3,2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e1.500\u003c/p\u003e\n \u003cp\u003e(1.1,1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e12.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e31.71\u003c/p\u003e\n \u003cp\u003e(30.14,34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e33.00\u003c/p\u003e\n \u003cp\u003e(30.0,35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e30.57\u003c/p\u003e\n \u003cp\u003e(27,33.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e15.658\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremature Rupture of Membranes\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eh\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e33.000\u003c/p\u003e\n \u003cp\u003e(7.5,72.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e44.500\u003c/p\u003e\n \u003cp\u003e(6.8,72.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e36.000\u003c/p\u003e\n \u003cp\u003e(12.0,96.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e0.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1-minute Apgar score.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e9.000\u003c/p\u003e\n \u003cp\u003e(8.0,9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e9.000\u003c/p\u003e\n \u003cp\u003e(8.0,9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e8.000\u003c/p\u003e\n \u003cp\u003e(7.0,9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e11.879\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.003*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5-minute Apgar score.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e9.000\u003c/p\u003e\n \u003cp\u003e(9.0,9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e9.000\u003c/p\u003e\n \u003cp\u003e(9.0,10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e9.000\u003c/p\u003e\n \u003cp\u003e(9.0,10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e12.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at NEC onset (days)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e14.000\u003c/p\u003e\n \u003cp\u003e(6.5,22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003cp\u003e(5.0,19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e9.000\u003c/p\u003e\n \u003cp\u003e(4.0,17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e10.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.006*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaboratory values at NEC onset\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eWhite blood cells (\u0026times;10⁹/L)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e9.540\u003c/p\u003e\n \u003cp\u003e(7.3,12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e10.400\u003c/p\u003e\n \u003cp\u003e(7.2,13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e8.080\u003c/p\u003e\n \u003cp\u003e(4.0,13.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e9.247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.010*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003ePlatelets (\u0026times;10⁹/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e287.000\u003c/p\u003e\n \u003cp\u003e(199.0,368.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e307.000\u003c/p\u003e\n \u003cp\u003e(214.0,395.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e189.000\u003c/p\u003e\n \u003cp\u003e(115.0,318.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e29.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eRed blood cells (\u0026times;10\u0026sup1;\u0026sup2;/L)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e3.780\u003c/p\u003e\n \u003cp\u003e(3.3,4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e3.800\u003c/p\u003e\n \u003cp\u003e(3.3,4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e3.705\u003c/p\u003e\n \u003cp\u003e(3.2,4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e2.584\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.275\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eHemoglobin (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e133.000\u003c/p\u003e\n \u003cp\u003e(115.0,159.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e135.000\u003c/p\u003e\n \u003cp\u003e(112.0,155.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e127.000\u003c/p\u003e\n \u003cp\u003e(102.8,152.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e3.431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eHematocrit (%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e39.000\u003c/p\u003e\n \u003cp\u003e(34.3,44.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e39.300\u003c/p\u003e\n \u003cp\u003e(32.5,45.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e37.500\u003c/p\u003e\n \u003cp\u003e(30.4,44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e1.849\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.397\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eSCr（\u0026mu;mol/L））\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e33.650(26.9,45.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e30.000(22.0,41.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e45.000(31.8,57.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e30.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003cstrong\u003eHospital stay (days)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e42.000\u003c/p\u003e\n \u003cp\u003e(27.0,59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e33.000\u003c/p\u003e\n \u003cp\u003e(20.0,57.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003e26.000\u003c/p\u003e\n \u003cp\u003e(16.0,61.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.3146%;\"\u003e\n \u003cp\u003e12.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9086%;\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5 Multivariate Regression Analysis of NEC Risk Factors\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 1: Unadjusted Multinomial Logistic Regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStage II NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ez\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eWald \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.553\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.379 ~ 0.879\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStage III NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ez\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eWald \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.674\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.240 ~ 0.751\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eMcFadden \u003cem\u003eR\u0026sup2;\u0026nbsp;\u003c/em\u003e= 0.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eCox \u0026amp; Snell \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.024\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eNagelkerke \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.028\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 2: Adjusted for GA, Birth Weight, Sex, Ethnicity, and Region\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStage II NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ez\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWald \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.975 ~ 1.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.669\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.358\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.492\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.968 ~ 3.941\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.697 ~ 1.697\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.485\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.927\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.565\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.094 ~ 0.626\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.920\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.777\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.633 ~ 0.952\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.663\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.683\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.515\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.332 ~ 0.801\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStage III NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ez\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eWald \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-3.498\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.948\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.920 ~ 0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.402\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.570\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.330 ~ 12.414\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.800\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.639\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.768\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.403 ~ 1.466\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-19.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3577.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.996\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000 ~ Infinity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-5.739\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32.937\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.304 ~ 0.558\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-3.885\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e15.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.152 ~ 0.538\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eMcFadden \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.105\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eCox \u0026amp; Snell \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.192\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eNagelkerke \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.220\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\" class=\"fr-table-selection-hover\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 3: Adjusted for Multiple Confounders\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStage II NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ez\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eWald \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.955\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.977 ~ 1.022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.666\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.858\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.899 ~ 4.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.397\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.689 ~ 1.754\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.490\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.724\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.419\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.101 ~ 0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.934\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.761 ~ 1.285\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.558\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.351 ~ 0.889\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eChorioamnionitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.699\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.595\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.864 ~ 7.793\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFeeding type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.982 ~ 1.234\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ehsPDA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.389\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.755 ~ 2.883\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory support at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.383\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.536\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.763 ~ 1.684\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStage III NEC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ez\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eWald \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.912 ~ 0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.853\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.552\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.512\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.537 ~ 26.482\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.385\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.835\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.703\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.331 ~ 1.496\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-19.769\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5627.988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000 ~ Infinity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.663\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.394 ~ 0.868\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eACS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-3.341\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.125 ~ 0.581\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eChorioamnionitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.656\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.388 ~ 18.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFeeding type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.904\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.751 ~ 1.088\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ehsPDA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.867\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.985\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.011 ~ 5.607\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory support at NEC onset\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.616\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.009 ~ 3.394\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eMcFadden \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.134\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eCox \u0026amp; Snell \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.235\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003eNagelkerke \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.272\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"prenatal corticosteroids, necrotizing enterocolitis, preterm infants, severity, protective effect","lastPublishedDoi":"10.21203/rs.3.rs-7698735/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7698735/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eOur study is a retrospective multicenter observational cohort study to investigate effect of the use of antenatal corticosteroids (ACS) in preterm infants on the severity of necrotizing enterocolitis (NEC) and its associated complications. We collect clinical data from 443 preterm infants with gestational age(GA) of less than 37 weeks who were diagnosed with NEC in four hospitals across various provinces in China from June 2020 to June 2024. The infants were categorized into an exposed group and a non-exposed group based on whether they received prenatal corticosteroid therapy. 213 preterm infants (48.08%) had received ACS therapy. When compared to the non-exposed group, the severity of NEC in the exposed group demonstrated a statistically significant difference (p=0.005). In the univariate regression analysis, ACS therapy was identified as a significant protective factor against the occurrence of hsPDA (OR=0.612, CI 0.385-0.974), BPD (OR=0.611, CI 0.377-0.989), and the need for surgical intervention (OR=0.609, CI 0.384-0.967). After adjusting for multiple confounding factors, ACS continued to demonstrate its protective effect against the severity of NEC (OR=0.269, CI 0.125-0.581). Therefor , ACS can reduce the severity of NEC and lower the incidence of hsPDA, BPD, and the necessity for surgical in preterm infants.\u003c/p\u003e","manuscriptTitle":"Prenatal Corticosteroid Use Improves the Severity and Complications of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Clinical Study in China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-19 11:55:55","doi":"10.21203/rs.3.rs-7698735/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e1e53d6f-ebfe-42dd-a74f-82bd41b9a0dd","owner":[],"postedDate":"November 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":57697598,"name":"Health sciences/Diseases"},{"id":57697600,"name":"Health sciences/Health care"},{"id":57697602,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-12-31T05:39:14+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-19 11:55:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7698735","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7698735","identity":"rs-7698735","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}