Published online January 3, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. e137-e142 (doi:10.1542/peds.2005-1543)

This Article Full Text Full Text (PDF) View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Guillet, R. Search for Related Content PubMed PubMed Citation Articles by Guillet, R. Related Collections Premature & Newborn Social Bookmarking                         What's this?

Association of H2-Blocker Therapy and Higher Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants

Ronnie Guillet, MD, PhD^a, Barbara J. Stoll, MD^b, C. Michael Cotten, MD^c, Marie Gantz, PhD^d, Scott McDonald, BS^d, W. Kenneth Poole, PhD^d, Dale L. Phelps, MD^a for members of the National Institute of Child Health and Human Development Neonatal Research Network

^a Department of Pediatrics, Division of Neonatology, University of Rochester, Rochester, New York
^d RTI International, Research Triangle Park, North Carolina
^b Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta at Egleston, Emory University, Atlanta, Georgia
^c Department of Pediatrics, Division of Neonatology, Duke University, Durham, North Carolina

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 randomized trial of acidification of infant feeds that resulted 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.

---

Key Words: prematurity • cimetidine • ranitidine • famotidine • necrotizing enterocolitis • H2 blockers

Abbreviations: NEC— necrotizing enterocolitis • H2—histamine-2 receptor • VLBW—very low birth weight • NICHD—National Institute of Child Health and Human Development • OR—odds ratio • CI—confidence interval

---

Accepted Aug 3, 2005.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				E. C. Eichenwald and A. R. Stark Management and Outcomes of Very Low Birth Weight N. Engl. J. Med., April 17, 2008; 358(16): 1700 - 1711. [Full Text] [PDF]

				M Chauhan, G Henderson, and W McGuire Enteral feeding for very low birth weight infants: reducing the risk of necrotising enterocolitis Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2008; 93(2): F162 - F166. [Abstract] [Full Text] [PDF]

eLetters:

Read all eLetters

Ranitdine and CPOE: and the beat goes on...

Dennis Costakos, et al.

Pediatrics Online, 1 Mar 2006 [Full text]