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TL;DR
FC levels were elevated before and at NEC onset, and infants with FI exhibited lower FC concentrations and delayed increases after meconium compared with non-FI infants.
Clinical and Translational Gastroenterology · 11 authors, 2 centres
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FC levels were elevated before and at NEC onset, and infants with FI exhibited lower FC concentrations and delayed increases after meconium compared with non-FI infants.
This prospective observational cohort study collected 1,086 weekly fecal samples from 194 very preterm infants (gestational age <32 weeks or birth weight <1,500 g). FC levels in non-NEC infants followed an age-dependent patterned progression during early life. FC levels were elevated in infants with NEC before and at onset, with cutoffs of 514 and 1,086 μg/g showing high sensitivity (93.3%) but low specificity for prediction and diagnosis, respectively. The age to reach first high nonmeconial FC levels was positively associated with time to achieve full enteral feeding. Limitations include reliance on weekly sampling that may miss rapid-onset NEC or sepsis events, exclusion of infants with gestational age ≥32 weeks, and use of an assay method that may yield higher FC values than other kits. The high variability in FC levels warrants caution in clinical application for NEC screening.