Background: Necrotizing enterocolitis (NEC) is a severe inflammatory gastrointestinal disease that affects premature neonates with high morbidity and mortality. We aimed to evaluate the potential of IgG anti-tissue transglutaminase antibodies (IgG tTG) as biomarkers for NEC and to explore their applicability in the early diagnosis, monitoring prognosis. Method: We conducted a prospective observational study on 60 neonates with abdominal distension, dividing into the NEC(n=30) and the control(n=30) groups according to the follow-up results. We collected plasma samples within 48 h of the onset of abdominal distension, and used the autoantigen microarray to screen for NEC-associated autoantibodies. Additionally, an Enzyme-linked immunosorbent assay (ELISA) was utilized to measure the levels of IgG tTG in a validation study that included 43 neonates with NEC and 20 gestational age- and weight-matched controls. Results: The autoantibody microarray analysis indicated that plasma levels of IgG tTG were significantly higher in neonates with NEC compared to controls ( P< 0.001). ELISA confirmed the significant elevation of plasma IgG tTG in neonates with NEC ( P<0.001). Plasma IgG tTG were able to distinguish NEC from the control group, with an area under the curve (AUC) of 0.8674 (95% confidence interval (CI): 0.7794 - 0.9555, sensitivity of 72.09% and specificity of 95%). Encouragingly, IgG tTG levels were significantly higher in NEC stage I than in the controls ( P < 0.001). Furthermore, as neonates with NEC showed clinical improvement, the levels of IgG tTG decreased ( P=0.0159). Conclusion: IgG tTG may serve as a biomarker for diagnosis early NEC and predict its prognosis.

Objective To determine the effects of antenatal corticosteroids treatment for congenital diaphragmatic hernia (CDH). Design A multicenter retrospectively study Setting Guangzhou Women and Children’s Medical Center, Guangdong Women and Children Hospital, Third Affiliated Hospital of Guangzhou Medical College. Methods Antenatal corticosteroids treatment was administered by intramuscular injection to mothers at 32 weeks of gestation (5mg twice a day for two days) depending of the clinical course and attending physician. Patients were divided into the observe group (39 cases) and the control group (40 cases). Main outcome measures Primary outcome was mortality. Secondary outcome was pulmonary arterial hypertension (PAH) Results: 79 cases (50 male and 29 females) were enrolled at 3 center. Of note, there was no significant difference in prenatal evaluation and the severity of PAH between this two group. The mortality of this two group was 17.% and 38.5% respectively (P=0.038). Observe group was associated with a lower survival(OR=0.3,95% CI=0.1-1.0, P=0.042). After adjusting for potential confounders, prenatal corticosteroids treatment was associated with a lower survival (OR=0.7, 95% CI=0.1 to 3.8, p=0.640）. Conclusion Antenatal corticosteroids treatment cannot improve the severity of PAH, nor improve the mortality. Instead,Antenatal corticosteroids treatment have been linked to increased mortality. Therefore, Antenatal corticosteroids treatment cannot be recommended in this data. Funding This study was supported by Guangdong Basic and Applied Basic Research Foundation, 2020A1515010296 Key words Congenital diaphragmatic hernia, prenatal corticosteroids intervention, mortality, pulmonary arterial hypertension Tweetable abstract Antenatal corticosteroids treatment seems cannot improve prognosis in patients with CDH.