Evaluation of Plasma D-Lactate Level in Preterm Infants with Necrotizing Enterocolitis

Background: Necrotizing enterocolitis (NEC) is a life -threatening condition of the intestines that manifests solely in premature newborns. Early identification of developing NEC is still challenging, as the current radiology and laboratory tests lack sufficient accuracy. Objective: The current study aimed to assess the role of plasma D-lactate as a diagnostic and prognostic biomarker for NEC.Methods: The study encompasses 30 preterm neonates diagnosed according to clinical and radiographic criteria as NEC, in addition to 30 preterm growing neonates as matched controls. An assay of plasma D- lactate levels was done by Enzyme-linked immunosorbent assay (ELISA). Results: The plasma D-lactate levels of NEC patients were significantly higher than to those of the controls (p  0.01). The levels of plasma D lactate also showed a statistically significant increase with worse prognosis of Bell's stage of the patients (p  0.01). The best cut-off point of D-lactate to identify cases with NEC was > 5.4 μmol/ml with diagnostic sensitivity and specificity of 100%. Conclusion: Measuring plasma D-lactate levels could be useful as a diagnostic biomarker in the early stage of NEC. Moreover, D-lactate levels can be correlated with the severity of the disease.