Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants
BACKGROUND Inhibitors of gastric acid ( IGA ) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants .
The result ant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis ( NEC ) .
Our systematic review examined the association between  IGA and NEC in preterm infants .
Association of H2-Blocker Therapy and Higher Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants
OBJECTIVE . We sought to determine if an association exists between the use of histamine-2 receptor ( H2 ) blockers and the incidence of  necrotizing enterocolitis ( NEC ) in infants of 401 to 1500 g in birth weight . STUDY DESIGN . Data from the National Institute of Child Health and Human Development Neonatal Research Network very low birth weight ( 401–1500 g ) registry from September 1998 to December 2001 were analyzed . The relation between the diagnosis of NEC ( Bell stage II or greater ) and antecedent H2-blocker treatment was determined by using case-control methodology . Conditional logistic regression was implemented , controlling for gender , site of birth ( outborn versus inborn ) , Apgar score of < 7 at 5 minutes , and postnatal steroids . RESULTS . Of 11072 infants who survived for at least 12 hours , 787 ( 7.1 % ) developed NEC ( 11.5 % of infants 401–750 g , 9.1 % of infants 751–1000 g , 6.0 % of infants 1001–1250 g , and 3.9 % of infants 1251–1500 g ) . Antecedent H2-blocker use was associated with an increased incidence of NEC ( P < .0001 ) . CONCLUSIONS . H2-blocker therapy was associated with higher rates of NEC , which is in agreement with a previous r and omized trial of acidification of infant feeds that result ed in a decreased incidence of NEC . In combination , these data support the hypothesis that gastric pH level may be a factor in the pathogenesis of NEC
Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants
BACKGROUND Inhibitors of gastric acid ( IGA ) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants .
The result ant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis ( NEC ) .
Our systematic review examined the association between  IGA and NEC in preterm infants .