Objective: In preterm infants, enteropathy or necrotising enterocolitis (NEC) are prominent features of digestive distress, impacting differently on enteral feeding. Their diagnosis, currently based on clinical and radiological data, would benefit from a non-invasive biological marker.
Patients and Methods: This retrospective multicentric study enrolled 126 preterm infants (75 boys, 51 girls) born at a median gestational age of 33 weeks (range 25.7–35 weeks) with a birth weight of 1760 g (730–2750 g). For each neonate, fecal samples were collected weekly from the end of the first week of life until the end of the first month and if any gastrointestinal event occurred. Samples were immediately stored at −80°C before ELISA measurement (Calprest, Eurospital, Italy).
Results: 312 samples were analysed. Median calprotectin value was 206 μg/g (16–1240), 393 μg/g (52–996) and 832 μg/g (168–4775) in samples from healthy neonates (252 samples), from neonates with mild digestive symptoms (42 samples) and from those with NEC (18 samples), respectively. Receiver operator characteristic curves analysis gave a cut-off value of 363 μg/g (sensitivity 0.65, specificity 0.82) for the development of digestive symptoms and a cut-off of 636 μg/g (sensitivity 0.72, specificity 0.95) for the development of severe symptoms.
Conclusion: Calprotectin might be a promising non-invasive clinical screening marker for intestinal distress in neonates. A prospective multicentric study is in progress to confirm its clinical utility.