INCREASE IN PLASMA PLATELET-ACTIVATING-FACTOR LEVELS IN ENTERALLY FEDPRETERM INFANTS

Because platelet-activating factor (PAF) has been implicated in the pa thogenesis of neonatal necrotizing enterocolitis (NEC), we designed a prospective study to examine plasma PAF levels during the first 14 day s of feeding in a population of neonates of less than 32 weeks gestati on. We found that significantly more patients had detectable plasma PA F levels on days 3 and 14 of feeding when compared to their prefeeding levels (7% on day 0 vs. 26% at day 3, p = 0.04; none on day 0 vs. 18. 5% at day 14, p = 0.01). This finding could not be explained by decrea sed plasma activity of acetylhydrolase, the PAF breakdown enzyme, spon taneous endotoxinemia or a maturational effect. None of the infants wh o developed detectable PAF levels after feedings were begun went on to develop NEC. We conclude that our findings may reflect increased inte stinal PAF production with the provision of feedings to some premature infants. However, this phenomenon by itself does not appear to be a s ufficient condition for the subsequent development of NEC.