Superior mesenteric artery Doppler after first feed and its association with feed intolerance and necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study.
HN, P., AK, J., LS, D., & AC, L. (2026). Superior mesenteric artery Doppler after first feed and its association with feed intolerance and necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study.. Journal of tropical pediatrics. https://doi.org/10.1093/tropej/fmag046
HN P, AK J, LS D, AC L. Superior mesenteric artery Doppler after first feed and its association with feed intolerance and necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study.. Journal of tropical pediatrics. 2026; doi: 10.1093/tropej/fmag046
HN P, AK J, LS D, et al. Superior mesenteric artery Doppler after first feed and its association with feed intolerance and necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study.[J]. Journal of tropical pediatrics. 2026. DOI: 10.1093/tropej/fmag046.
@article{hn2026,
author = {Patil HN and Joshi AK and Deshmukh LS and Londhe AC},
title = {Superior mesenteric artery Doppler after first feed and its association with feed intolerance and necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study.},
journal = {Journal of tropical pediatrics},
year = {2026},
doi = {10.1093/tropej/fmag046},
note = {PMID: 42365608},
}
TY - JOUR AU - Patil HN AU - Joshi AK AU - Deshmukh LS AU - Londhe AC TI - Superior mesenteric artery Doppler after first feed and its association with feed intolerance and necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study. T2 - Journal of tropical pediatrics PY - 2026 DO - 10.1093/tropej/fmag046 AN - PMID:42365608 ER -
To evaluate the association of superior mesenteric artery (SMA) Doppler parameters after the first feed with feed intolerance and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) neonates. This prospective cohort study was conducted in a tertiary neonatal intensive care unit from July 2024 to January 2025. VLBW neonates underwent SMA Doppler assessment before and 60 min after the first feed using standardized protocols. The primary outcome was time to full enteral feeds; secondary outcomes included feed intolerance, NEC, and sepsis. Fifty neonates were included. Post-feed resistive index (RI) decreased significantly (0.76-0.68; P = .01). On adjusted analysis, SMA Doppler parameters were not independently associated with time to full feeds, while respiratory distress syndrome (RDS) and hemodynamically significant patent ductus arteriosus (hsPDA) were significantly associated. Median time to full feeds was 9 days on Kaplan-Meier analysis. Neonates with feed intolerance had lower post-feed pulsatility index (PI) and RI, and a greater fall in RI. ROC analysis showed modest discrimination (AUC 0.69, 95% CI 0.53-0.84). Doppler differences in neonates with NEC were not statistically significant; an exploratory model showed modest discrimination (AUC 0.72, 95% CI 0.50-0.87). SMA Doppler parameters show possible association with feed intolerance and NEC but have limited predictive value as standalone markers. Feeding progression appeared to be more strongly influenced by systemic illnesses such as RDS, hsPDA, and by clinical management factors including feed withholding and individualized advancement decisions.