Background:Bronchopulmonary dysplasia (BPD) is a major respiratory morbidity in preterm infants and remains an important cause of adverse short- and long-term outcomes. Early postnatal nutrition may influence lung growth and injury repair, and intravenous lipid emulsions are a key component of parenteral nutrition in very preterm infants. Compared with conventional medium-chain/long-chain triglyceride fat emulsions (MCT/LCT), multi-oil fat emulsion (SMOF) contains fish oil and vitamin E, etc., and has a lower relative proportion of ω-6 fatty acids, and may theoretically attenuate inflammation and oxidative stress. However, current evidence regarding whether SMOF reduces the incidence of BPD remains inconsistent. This study aimed to evaluate the association between SMOF and BPD in preterm infants born at <32 weeks' gestation. Methods:A retrospective analysis included 171 preterm infants (<32 weeks) admitted to a tertiary neonatal intensive care unit, divided into SMOF (n=96) and MCT/LCT (n=75) groups. The outcome of respiratory system and other complications such as parenteral nutrition-related cholestasis (PNAC), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), late-onset of sepsis (LOS), brain injury and mortality were compared between the two groups. Results:Among the 171 preterm infants in the study, the mean gestational age was 29.51±1.55 weeks, with birth weight of 1,229.39±299.06 g. Multivariate analysis identified SMOF as an independent protective factor against BPD [odds ratio (OR) =0.317, 95% confidence interval (CI): 0.128-0.784]. No significant differences were observed in PNAC, ROP, NEC, sepsis, brain injury, or mortality between groups. Conclusions:We preliminarily conclude that SMOF is a potentially protective factor for BPD in preterm infants <32 weeks without increasing complications such as PNAC, ROP, NEC, sepsis, and brain injury. These findings may support its clinical utility in this population.

BackgroundNeonatal heart failure (HF) is a severe condition associated with high mortality because of immature organ function and limited cardiovascular reserve. However, studies focusing specifically on HF in neonates remain limited. This study aimed to characterize the clinical features of neonatal HF and identify factors associated with mortality, with additional analyses according to etiology and gestational age.MethodsThis retrospective study included 89 neonates diagnosed with HF and admitted to our hospital between June 2016 and December 2025. Patients were classified into survival and death groups and were further stratified by etiology and gestational age (<34 weeks vs. ≥ 34 weeks). Logistic regression analyses were performed to identify factors associated with mortality, and model discrimination was evaluated using receiver operating characteristic (ROC) analysis.ResultsThe overall mortality was 31.5%. The primary causes of HF were critical congenital heart disease (28%), severe arrhythmia (13%), pulmonary hypertension (12%), extremely severe anemia (12%), and perinatal asphyxia (10%). Compared with the survival group, the death group had lower birth weight, lower Apgar scores, higher N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, lower left ventricular ejection fraction (LVEF), and higher rate of fetal distress, respiratory failure, and shock. Multivariable analysis showed that fetal distress (OR, 7.70) and oliguria (OR, 7.32) were associated with higher mortality, whereas higher LVEF (OR per 1% increase, 0.94) was associated with lower mortality. The combined model had an AUC of 0.806 (95% CI, 0.702–0.909). In subgroup analysis, neonates born at <34 weeks had higher NT-proBNP levels, longer durations of invasive and non-invasive mechanical ventilation, longer hospital stays, higher rates of fetal distress, bronchopulmonary dysplasia and anemia, greater use of pulmonary surfactant, and higher mortality than those born at ≥34 weeks. No significant interactions by gestational age were observed for fetal distress, oliguria, or LVEF.ConclusionsNeonatal HF is associated with substantial mortality and is most commonly attributable to critical congenital heart disease, severe arrhythmia and other underlying conditions. Fetal distress and oliguria were independently associated with higher mortality, whereas higher LVEF was associated with lower mortality. Early recognition and targeted management are particularly important in preterm and other high-risk neonates.

The relationship between antenatal corticosteroids (ACS) and preterm infants born to mothers with hypertensive disorders of pregnancy (HDP) remains a subject of debate. To evaluate whether the use of ACS before delivery was associated with neonatal outcomes in very preterm infants born to mothers with HDP. This multicenter cohort study enrolled all infants with gestational age at 24 to 31 week and admitted to tertiary NICUs of the Chinese Neonatal Network (CHNN) within 24 h of birth from 2019 to 2021. ACS administration was defined as at least one dose of dexamethasone or betamethasone before delivery. The primary outcome was surfactant and/ or invasive mechanical ventilation (IMV) within 72 h of life. Multivariable logistic regression analyses were performed to assess the association between ACS and neonatal outcomes. Among the 4,582 study infants born to mothers with HDP, 3,806 (83.1

Autosomal recessive congenital ichthyosis is a group of skin disorders characterized by abnormal keratinization. The collodion baby phenotype is a rare phenotype of autosomal recessive congenital ichthyosis characterized by a tight, translucent membrane that encases the newborn, which leads to significant medical challenges. This case report describes a male infant born at 35 weeks and 6 days of gestation who presented with the collodion baby syndrome. The present case exhibited a nonbullous congenital ichthyosiform erythroderma–like phenotype, characterized by diffuse erythema and fine scaling. Genetic analysis revealed two compound heterozygous mutations in TGM1 : c.425G>T (p.Arg142Leu) in exon 3, previously reported as a pathogenic hotspot in nonbullous congenital ichthyosiform erythroderma, and a novel mutation, c.1198A>C (p.Asn400His) in exon 8, which has not only been associated with lamellar ichthyosis but has also been detected in nonbullous congenital ichthyosiform erythroderma. A comprehensive treatment strategy focused on symptom alleviation and supportive care led to significant improvement, and the infant was discharged after 6 days of hospitalization. This case highlights the importance of early diagnosis, multidisciplinary care, and genetic testing in managing autosomal recessive congenital ichthyosis. The identification of novel TGM1 mutations contributes to the expanding mutation spectrum and may inform future diagnostic and therapeutic approaches.

Neuronal development in newborns is often constrained by perinatal inflammation, with limited research available on the pathogenesis and treatment strategies for this condition. This study aimed to investigate the neuroprotective effects of Embelin in mitigating perinatal inflammation-induced neuronal development limitations by targeting 5-lipoxygenase (5-LOX) and reducing oxidative stress and ferroptosis. This study utilized in vivo and in vitro inflammation models to assess the therapeutic potential of Embelin, a small molecule drug from the FDA compound library. Using Autodock software and surface plasmon resonance detection technology, 5-LOX was identified as the molecular target of Embelin. Neuronal ferroptosis and oxidative stress were analyzed in rat models and PC12 cells treated with lipopolysaccharide (LPS) and Embelin. Biochemical assays, immunofluorescence staining, and western blotting were performed to quantify protein expression and oxidative stress markers. Embelin, along with the 5-LOX inhibitor Zileuton and 5-LOX mRNA silencing, significantly inhibited 5-LOX expression in neurons. Conversely, overexpressed 5-LOX promoted ferroptosis, and this effect could be inhibited by Embelin. These interventions reduced oxidative stress, suppressed ferroptosis, and promoted normal neuronal development in the cerebral cortex and hippocampus. The findings highlight Embelin's ability to specifically target and mitigate 5-LOX-induced ferroptosis, facilitating recovery from perinatal inflammation-induced neurodevelopmental deficits. Embelin demonstrates significant neuroprotective potential by inhibiting 5-LOX-mediated ferroptosis and oxidative stress, offering a promising therapeutic strategy for perinatal brain injury and related neurodevelopmental disorders.

Cytomegalovirus (CMV) infection is a common perinatal viral infection. Most CMV infections are asymptomatic; only a part of them present with symptoms, particularly in infants fed fresh breast milk. This article reports a case of two extremely preterm twins who simultaneously developed severe breast milk-acquired CMV infection. By reviewing the medical records of two infants, observing their clinical symptoms, collecting laboratory test results (including blood routine, biochemistry, inflammatory indicators, etc.), and conducting continuous monitoring of CMV-DNA in blood, urine, and breast milk, the research results were obtained. Both infants presented with sepsis-like syndrome: fever, apnea, pneumonia with respiratory failure, neutropenia, and thrombocytopenia, but antibiotic treatment was ineffective. Finally, the diagnosis of breast milk-acquired CMV infection was confirmed by testing of CMV DNA. Severe breast milk-acquired CMV infection occurring simultaneously in preterm twins was extremely rare. In clinical practice, early detection, timely diagnosis, and positive intervention are key points for breast milk-acquired CMV infection.

Pulmonary artery thrombosis in neonates is a rare entity. We describe a neonate with this diagnosis as well as his presentation, evaluation, and management. This case highlights the importance of cardiac ultrasound screening for neonates with high risk factors for pulmonary artery thrombosis without clinical symptoms, as it is not easily detected. Here, we present an unusual case of a Chinese premature infant, born to a diabetic mother, in whom thrombosis developed in the main pulmonary artery 12 days after an exploratory laparotomy. The preterm infant had no clinical manifestations of pulmonary artery thrombosis, which was found by reexamination of cardiac ultrasound before discharge; after treatment with low-molecular-weight heparin sodium, the embolus became smaller, and follow-up examination was conducted after discharge, and the baby is now developing well. Pulmonary artery thrombosis is rare in newborns, and asymptomatic manifestations are even rarer in this age group. For newborns with high risk factors, early cardiac ultrasound screening is very important.

INTRODUCTION:We aimed to evaluate whether the incidence of pneumothorax is associated with adverse neonatal outcomes in very preterm infants. METHODS:This multicenter cohort study included all infants with a gestational age of 24-31 weeks, admitted to the tertiary neonatal intensive care units of the Chinese Neonatal Network, from 2019 to 2022. Pneumothorax was diagnosed via chest X-ray or lung computed tomography. The primary outcome was a composite measure of mortality and/or any severe neonatal morbidity. Multivariable logistic or linear regression analyses were performed to assess the association between pneumothorax and neonatal outcomes. Propensity score matching was used to ensure the robustness of the results. RESULTS:Among the 37,917 infants in the study, 465 (1.2%) developed pneumothorax. Pneumothorax was significantly associated with a higher risk of mortality and/or severe neonatal morbidity (adjusted odds ratio = 3.15, 95% confidence interval: 2.36, 4.20). Pneumothorax exposure was also independently associated with increased mortality, severe intraventricular hemorrhage, moderate or severe bronchopulmonary dysplasia, and the need for invasive ventilation and its duration. Additionally, pneumothorax was associated with an increased length of hospital stay among survivors (adjusted odds ratio = 7.62, 95% confidence interval: 4.33, 10.91). The usage of high-frequency invasive mechanical ventilation before pneumothorax and pneumothorax treated with an intercostal chest drain seemed to have the most significant harmful effect (adjusted odds ratios were 3.34 and 3.27, respectively). CONCLUSION:Our study underscores the significant impact of pneumothorax on increasing mortality and severe morbidities in very preterm infants.

BackgroundHereditary hemorrhagic telangiectasia (HHT) is a rare genetic disease. The prevalence of pulmonary arterial hypertension (PAH) in HHT patients is less than 1%. Severe pulmonary hypertension (PH) in pregnant woman due to HHT and reversible pulmonary hypertension in her neonate is even rarer.MethodsCases of mother and newborn with PH are presented, including their clinical manifestations, diagnosis, and treatment. Additionally, literatures were reviewed to explore the various causes of the disease.ResultsThe mother was diagnosed with HHT caused by an ACVRL1 gene variant, with her PH occurring as a complication of HHT type 2 (HHT2). The neonate was confirmed to be free of the ACVRL1 gene variant, and her PH resulted from impaired placental perfusion and adverse intrauterine environment secondary to severe maternal PH and anemia.ConclusionAttention should be paid to the progression of the disease and the comprehensive management strategies during pregnant HHT patient. Moreover, neonates born to HHT-affected mothers require evaluation for both HHT-related PH and reversible PH secondary to adverse intrauterine factors. This report aims to enhance the recognition of familial manifestations of HHT and raise awareness of the occurrence of postnatal PH in neonates of mothers with HHT, thereby facilitating early detection and timely intervention.

ObjectiveThis study aimed to investigate the correlation between serum 25-hydroxyvitamin D (25(OH)D) levels and retinopathy of prematurity (ROP) in premature infants one month after birth.MethodsPreterm infants (gestational age <32 weeks) admitted to the Affiliated Hospital of Qingdao University from 2017 to 2022 were divided into ROP and non-ROP groups based on ROP occurrence any stage. Serum 25(OH)D levels and clinical data were compared between the two groups at 1 month after birth, and the relationship between vitamin D levels and ROP was analyzed.ResultsAmong the 217 premature infants included, 55 (25.35%) were in the ROP group, and 162 (74.65%) were in the non-ROP group. The ROP group had lower gestational age and birth weight, longer invasive ventilation (IV), non-invasive ventilation (NIV), and oxygen therapy times compared to the non-ROP group. Apgar scores, cesarean delivery, and antenatal steroids ratios were lower in the ROP group, while sepsis and pulmonary surfactant utilization ratios were higher (all p < 0.05). Significant differences in serum 25-(OH)D levels were observed among children in the non-ROP group (14.20 ± 5.07 ng/ml), ROP treated group (7.891 ± 1.878 ng/ml), and untreated group (12.168 ± 4.354 ng/ml) (p < 0.001). Multivariate regression analysis identified antenatal steroids as protective factors and lower birth weight, serum 25-(OH)D levels, long-term invasive mechanical ventilation, and sepsis as independent risk factors for ROP in premature infants.ConclusionVitamin D, lower birth weight, long-term invasive mechanical ventilation, and sepsis were associated with incidence of ROP in preterm infants. Vitamin D was associated with the severity of ROP, emphasizing the importance of prudent vitamin D supplementation and regular monitoring of serum 25-(OH)D levels.

Objective As the predominant complication in preterm infants, Bronchopulmonary Dysplasia (BPD) necessitates accurate identification of infants at risk and expedited therapeutic interventions for an improved prognosis. This study evaluates the potential of Monosaccharide Composite (MC) enriched with environmental information from circulating glycans as a diagnostic biomarker for early-onset BPD, and, concurrently, appraises BPD risk in premature neonates. Materials and methods The study incorporated 234 neonates of ≤32 weeks gestational age. Clinical data and serum samples, collected one week post-birth, were meticulously assessed. The quantification of serum-free monosaccharides and their degraded counterparts was accomplished via High-performance Liquid Chromatography (HPLC). Logistic regression analysis facilitated the construction of models for early BPD diagnosis. The diagnostic potential of various monosaccharides for BPD was determined using Receiver Operating Characteristic (ROC) curves, integrating clinical data for enhanced diagnostic precision, and evaluated by the Area Under the Curve (AUC). Results Among the 234 neonates deemed eligible, BPD development was noted in 68 (29.06%), with 70.59% mild (48/68) and 29.41% moderate-severe (20/68) cases. Multivariate analysis delineated several significant risk factors for BPD, including gestational age, birth weight, duration of both invasive mechanical and non-invasive ventilation, Patent Ductus Arteriosus (PDA), pregnancy-induced hypertension, and concentrations of two free monosaccharides (Glc-F and Man-F) and five degraded monosaccharides (Fuc-D, GalN-D, Glc-D, and Man-D). Notably, the concentrations of Glc-D and Fuc-D in the moderate-to-severe BPD group were significantly diminished relative to the mild BPD group. A potent predictive capability for BPD development was exhibited by the conjunction of gestational age and Fuc-D, with an AUC of 0.96. Conclusion A predictive model harnessing the power of gestational age and Fuc-D demonstrates promising efficacy in foretelling BPD development with high sensitivity (95.0%) and specificity (94.81%), potentially enabling timely intervention and improved neonatal outcomes.

X-linked intellectual developmental disorder is a rare X-linked genetic disease, manifested as heart disease, intellectual impairment, and developmental disorders.We report a male infant who presented with dyspnea after birth. Physical examination on admission revealed poor responsiveness, deep eye sockets, a small mandible, abnormalities of the outer ears, and reduced limb muscle tone. The child was moaning with shortness of breath and a positive three-concave sign without pulmonary rales. The heart sounds were weak with a grade 2/6 diastolic heart murmur. Echocardiography showed an enlarged heart with increased trabeculae in the left ventricular muscle wall. X-linked mental retardation syndrome type 34(MRXS34, OMIM# 300967) was diagnosed after exome sequencing showed a c.1131G > A hemizygous variant in the NONO gene. After timely therapy including respiratory support, cardiac glycosides, and diuresis, the child's condition improved and he was discharged at one month of age.A literature review showed that, to date, 22 live births with X-linked mental retardation have been reported. The NONO-related phenotype can be summarized as a neurological and cardiac developmental disorder, which may be accompanied by multisystem malformations. The present case enriches the knowledge of X-linked intellectual developmental syndromes.

Objective To investigate the clinical features of neonates with enterovirus encephalitis, and to prevent the outbreak of enterovirus infection by improving the early identification of this disease. Methods A total of 12 neonates with enterovirus encephalitis who were admitted to our hospital from June 2019 to June 2022 were enrolled and analyzed in terms of clinical features and laboratory examination. The key points of treatment were summarized, and their prognosis was assessed. ResultsAmong the 12 neonates, 7 were preterm infants, with the clinical manifestations of nonspecific sepsis-like symptoms and normal or mildly elevated inflammatory markers. All neonates tested positive for enterovirus nucleic acid in cerebrospinal fluid. All neonates were given standard isolation, intravenous injection of human immunoglobulin, and symptomatic supportive treatment and achieved a good prognosis after treatment. Conclusion Neonates with enterovirus encephalitis often have atypical clinical manifestations and thus require early identification and targeted strategies for the prevention and control of infection.

We describe an outbreak of echovirus 18 infection involving 10 patients in our neonatal intensive care unit (an attack rate of 33%). The mean age at the onset of illness was 26.8 days. Eighty percent were preterm infants. All were discharged home without sequelae. There were no differences in gestation age, birth weight, delivery mode, use of antibiotics, and parenteral nutrition between the enterovirus (EV) group and non-EV group, but the rate of breastfeeding was significantly higher in the EV group. Separation care and reinforcement of hand-washing seemed to be effective in preventing further spread of the virus. Visiting policy, hygiene practice, and handling of expressed breastmilk should be reinforced.

Objective:To investigate the clinical characteristics of congenital esophageal atresia with gastric perforation, and to improve pediatricians′ understanding of this disease.Methods:The clinical data of five neonates with congenital esophageal atresia and gastric perforation treated in the neonatal intensive care unit of the Affiliated Hospital of Qingdao University from 2012 to 2022 were analyzed retrospectively.Results:Among the five neonates, four were boys and one was girl.The gestational age was 28 + 5 to 37 + 6 weeks, the birth weight was 1 100~2 350 g. All of them had dyspnea and feeding difficulties after birth.Gastric perforation occurred in three cases during invasive mechanical ventilation, one case during non-invasive ventilation, and one case during nasal catheter oxygen inhalation.Emergency primary gastric repair was performed, followed by secondary esophageal anastomosis.All the patients were cured and discharged from hospital. Conclusion:Gastric perforation is a rare complication of congenital esophageal atresia, which is more common in premature infants and low birth weight infants.Mechanical ventilation may promote the occurrence of gastric perforation.If gastric perforation is complicated, repair should be performed as soon as possible, and esophageal anastomosis surgery should be performed early after stability to improve the final outcome.

Objective:To study the risk factors and clinical outcomes of early pulmonary hypertension in preterm infants with gestational age(GA)≤32 w.Methods:From October 2017 to May 2021,preterm infants with GA≤ 32 w admitted to NICU of our hospital were retrospectively studied. According to their echocardiography 2 w after birth, the infants were assigned into early-onset pulmonary hypertension (ePH) group and non-PH group. SPSS 21.0 statistical software was used to analyze the general status, complications and clinical outcomes of the two groups. Multiple logistic regression was used to analyze the risk factors of early-onset PH.Results:A total of 183 cases were enrolled, including 24 in the ePH group and 159 in the non-PH group. The incidences of birth asphyxia, hemodynamically significant patent ductus arteriosus (hsPDA), FiO 2≥30% within 6 h after birth, late-onset PH, severe bronchopulmonary dysplasia(BPD) and intracranial hemorrhage(ICH) in the ePH group were significantly higher than the non-PH group( P<0.05). hsPDA was the independent risk factor for early-onset PH ( OR=11.781, 95% CI 4.192-33.108). Conclusions:Preterm infants with GA≤32 w and early-onset PH are at increased risks of ICH, late-onset PH and severe BPD, hsPDA is the independent risk factor for early-onset PH.

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/bync-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work. An Outbreak of Nosocomial Infection of Neonatal Aseptic Meningitis Caused by EV18 1 2 Hongmin Xi, M.M.1, Yi Tian, BSFS2, Hui Shao, MBBCH1, Xiangyun Yin, M.M.1, Lili Ma, 3 M.M.1, Ping Yang, M.M.1, Xianghong Li, M.M.1* 4 5 1Neonatology Department, The Affiliated Hospital of Qingdao University, NO.16 Jiangsu 6 Road, Shinan district, Qingdao 266003, Shandong China 7 2Jining Medical University, 133 Hehua Rd, Jining, 272067, China 8

Objective:To investigate the risk factors for bronchopulmonary dysplasia (BPD) combined with metabolic bone disease (MBD) in premature infants.Methods:A total of 151 preterm infants with BPD admitted to Neonatal Intensive Care Unit (NICU) of the Affiliated Hospital of Qingdao University from January 1, 2018 to December 31, 2020 were selected into this study. According to whether BPD infants had MBD or not, they were divided into BPD complicated with MBD group (n=41) and BPD alone group (n=110). Retrospective analysis was performed to analyze the clinical case data, the occurrence of other complications except MBD, the treatment time of non-invasive positive pressure ventilation and invasive mechanical ventilation, drug treatment, serum biochemical indexes, enteral and parenteral nutrition between two groups.Pearson column correlation number was used to analyze the correlation between the severity of BPD and MBD between two groups. The statistically significant variables in the univariate analysis were included in the multivariate unconditional logistic regression analysis to explore influencing factors of BPD combined with MBD in preterm infants.The research procedures followed in this study were approved by the Medical Ethics Committee of the Affiliated Hospital of Qingdao University (QYFY WZLL 26771), and written informed consents were obtained from all guardians of the children.Results:① The gestational age and birth weight of BPD complicated with MBD group were lower than those of BDP alone group, and the differences were statistically significant (P<0.05). ② The duration of non-invasive positive pressure ventilation and hospital stay of BPD complicated with MBD group were both longer than those in BPD alone group, and the difference was statistically significant (P<0.05). The incidence of neonatal sepsis and neonatal necrotizing enterocolitis (NEC) in BPD complicated with MBD group during hospitalization were higher than those in BPD alone group, and the difference were statistically significant (P<0.05). ③ There were statistically significant differences in the concentration of 25-hydroxyvitamin D[25 (OH) D], serum alkaline phosphatase (ALP) and blood phosphorus between two groups at the first and 21st day after the birth (P<0.05). ④ The parenteral nutrition time and breastfeeding time of BPD complicated with MBD group were longer than those of BPD alone group, and the differences were statistically significant (P<0.05). On the 28th day after birth, total calories, enteral nutrient calories, enteral protein and parenteral amino acids in BPD complicated with MBD group were lower than those in BPD alone group, and the differences were statistically significant (P<0.05). ⑤ There was a significant positive correlation between the severity of BPD and MBD in premature infants of BPD complicated with MBD (r=0.381, P<0.05). ⑥ Multivariate logistic regression analysis of MBD in premature infants with BPD showed that non-invasive positive pressure ventilation time (OR=1.043, 95%CI: 1.015-1.072, P=0.003) and parenteral nutrition time (OR=1.041, 95%CI: 1.008-1.075, P=0.014), all of which were independent risk factors for MBD in premature infants with BPD. Serum 25(OH)D level at day 21 of birth was an independent protective factor for MBD in premature infants with BPD (OR=0.919, 95%CI: 0.858 ~ 0.984, P=0.015).Conclusions:Increased serum 25(OH)D level within 3 weeks after birth can reduce the risk of MBD in preterm infants with BPD. Early after birth, premature infants with BPD should be given active enteral nutrition support to ensure appropriate serum 25(OH)D level, and bone metabolism indexes should be evaluated regularly, so as to reduce the probability of developing MBD in premature infants with BPD, and to improve the prognosis and long-term outcome of children with BPD and MBD.

Objective:To investigate the clinical application of multi-oil fat emulsion (SMOF) in preterm infants with necrotizing enterocolitis (NEC).Methods:Preterm infants with NEC admitted to the Neonatal Intensive Care Unit in our hospital between January 2017 and December 2022 were retrospectively included. According to the type of fat emulsion used, they were divided into SMOF group and medium and long chain triglycerides (MCT/LCT) group. The data of two groups were compared and analyzed.Results:A total of 69 preterm infants were included, 34 in the SMOF group and 35 in the MCT/LCT group. There were no significant differences between the two groups in the levels of total bilirubin, indirect bilirubin, direct bilirubin, bile acid and γ-glutamyl transferase ( P>0.05). There were no significant differences between the two groups in triglyceride, low density lipoprotein and total cholesterol ( P>0.05). There were no significant differences between the two groups in the C reactive protein level, procalcitonin level, and the time to normal C reactive protein ( P>0.05). There were no significant differences in incidence of complications between the two groups, including parenteral nutrition-related cholestasis, bronchopulmonary dysplasia, retinopathy of prematurity, and brain injury ( P>0.05). Conclusions:Compared with MCT/LCT, the application of SMOF did not show significant effect on liver function, inflammation, or incidence of complications (parenteral nutrition-related cholestasis, bronchopulmonary dysplasia and retinopathy of prematurity) in preterm infants with NEC. Multi-center studies with larger sample size are needed for further investigation.