Elevated day-2 hemoglobin P₅₀ and risk of necrotizing enterocolitis in preterm infants: a pilot study
Pediatric Surgery International, cilt.42, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 42 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00383-025-06269-3
- Dergi Adı: Pediatric Surgery International
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Necrotizing enterocolitis, Hemoglobin P-5(0), Biomarker, Preterm infant, Oxygen affinity
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: To evaluate whether hemoglobin P₅₀, automatically calculated from routine blood gas analyses, can serve as a practical early biomarker for necrotizing enterocolitis (NEC) in preterm infants. Methods: We retrospectively analyzed 117 preterm infants born at < 32 weeks’ gestation who were admitted to a tertiary NICU between 2022 and 2024. Hemoglobin P₅₀ and serum lactate values were obtained from arterial blood gases on postnatal days 1–3. NEC was defined according to modified Bell’s criteria (stage ≥ II). Discriminative performance was assessed using receiver operating characteristic (ROC) analysis, with a prespecified P₅₀ threshold of 21.0 mmHg. Results: NEC developed in 27 infants (23%). Mean day-2 P₅₀ was significantly higher in the NEC group compared with controls (22.5 ± 6.8 vs. 18.9 ± 3.6 mmHg; p = 0.03). Day-2 P₅₀ predicted NEC with moderate accuracy (AUC 0.70, 95% CI 0.56–0.83), outperforming lactate (AUC 0.52, 95% CI 0.38–0.67). At the 21.0 mmHg cutoff, sensitivity was 67%, specificity 72%, positive predictive value 41.8%, and negative predictive value 87.9%. Conclusion: Day-2 hemoglobin P₅₀ was elevated in infants who subsequently developed NEC. These preliminary findings indicate that P₅₀ may be a feasible, cost-effective biomarker for early NEC risk stratification; however, larger prospective studies are required to validate its predictive utility.