Göpel W, et al. - Here the experts tested the hypothesis that polymorphisms, which were known modifiers of intestinal iron uptake in adults, were associated with necrotizing enterocolitis (NEC) in preterm infants. Their investigations suggested that polymorphisms inducing lower intestinal iron uptake like the rs855791 A-allele might be an underestimated risk factor for NEC.

Methods

• In this study, preterm infants (birth weight below 1,500 g) were evaluated.
• With the aid of PCR, single-nucleotide polymorphisms with known effects on serum iron levels (rs1800562, rs1799945, and rs855791) were analyzed.
• With Mendelian randomization, the effects of polymorphisms on NEC surgery were explored.
• Outcome data were compared with χ²-test, Fisher’s exact test, t-test, and Cochran–Armitage test for trend and multiple logistic regression analysis.

Results

• For 11,166 infants, complete genotyping data were available.
• High serum iron levels due to rs855791 genotype were associated with a significantly reduced risk of NEC surgery (odds ratio (OR) 0.265; 95% confidence interval (CI) 0.11–0.65; adjusted P=0.011).
• Carriers of the rs855791 A-allele not receiving prophylactic probiotics had a higher risk of NEC surgery (OR 1.12, 95% CI 1.08–1.70, nominal P=0.002).
• In carriers of the rs855791 A-Allele, prophylactic treatment with probiotics was associated with a reduced risk of NEC surgery.
•  No differences were found with regard to other short- or long-term outcome data.