Serial fecal calprotectin in the prediction of necrotizing enterocolitis in preterm neonates

To investigate whether serial measurements of fecal calprotectin concentrations enable us to identify infants who will develop NEC prior to development of symptoms. Prospective matched case–control study including 100 high-risk neonates. High risk includes 1) gestational age (GA) ≤30 weeks, 2) birth-weight (BW) ≤1000 g, 3) GA 30–32 weeks and BW ≤1250 g, 4) born from a mother who received indomethacin for tocolysis. We matched every NEC subject with three controls for birth weight and gestational age. Fecal calprotectin was measured twice a week from day one until five weeks after birth or until NEC development. We analyzed differences in fecal calprotectin between NEC subjects and controls in the week preceding NEC onset and course of fecal calprotectin within subjects who developed NEC. Of 100 included patients, ten (median GA 27.5 weeks [24.6–29.4], BW 1010 g [775–1630]) developed NEC. The median calprotectin concentration in all samples combined was 332 μg/g [