Necrotising enterocolitis in newborns receiving diazoxide
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jan 2021 · 1 min read
In brief
In brief
Retrospective cohort study of 55 neonates treated with diazoxide for persistent hypoglycemia found a significantly elevated risk of necrotizing enterocolitis (13% incidence), particularly in late preterm infants (33-36 weeks). Most NEC cases developed within 7 days of diazoxide initiation, suggesting clinicians should monitor closely for feeding intolerance when using this medication in newborns.
Written by the GCMD Library team from the article.
Background: Frequent and severe gastrointestinal disturbances have been reported with the use of diazoxide in adults and older children. However, no studies have investigated the incidence of necrotising enterocolitis (NEC) in diazoxide-exposed newborns.
Objective: To evaluate a possible association between diazoxide treatment for neonatal hypoglycaemia and the occurrence of NEC.
Design: Multicentre retrospective cohort study.
Setting: Three tertiary neonatal intensive care units in Toronto, Canada.
Patients: All patients treated with diazoxide for persistent hypoglycaemia between July 2012 and June 2017 were included. Overall incidence of NEC during those years on the participating units was obtained for comparison from the Canadian Neonatal Network database.
Main outcome: Incidence of NEC after diazoxide exposure.
Results: Fifty-five neonates were exposed to diazoxide during the study period. Eighteen patients (33%) showed signs of feeding intolerance, and 7 developed NEC (13%). A diagnosis of NEC was more prevalent in the diazoxide-exposed, as compared with non-exposed infants of similar gestational age (OR 5.07, 95% CI 2.27 to 11.27; p<0.001), and greatest among infants born at 33-36 weeks' gestation (OR 13.76, 95% CI 3.77 to 50.23; p<0.001). All but one of the neonates diagnosed with NEC developed the disease within 7 days from initiation of diazoxide treatment.
Conclusion: The present data suggest a possible association between diazoxide exposure and the development of NEC in neonates. Further evaluation of the diazoxide-associated risk of NEC in neonates treated for persistent hypoglycaemia is warranted.
DOI: 10.1136/archdischild-2020-319057