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Population-based study showed that necrotising enterocolitis occurred in space-time clusters with a decreasing secular trend in Sweden.

Journal article
Authors Amanda Magnusson
Margareta Ahle
Diana Swolin-Eide
Anders Elfvin
Roland E Andersson
Published in Acta paediatrica
Volume 106
Issue 7
Pages 1097-1102
ISSN 0803-5253
Publication year 2017
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 1097-1102
Language en
Subject categories Pediatrics


This study investigated space-time clustering of neonatal necrotising enterocolitis over three decades.Space-time clustering analyses objects that are grouped by a specific place and time. The Knox test and Kulldorff's scan statistic were used to analyse space-time clusters in 808 children diagnosed with necrotising enterocolitis in a national cohort of 2,389,681 children born between 1987-2009 in Sweden. The municipality the mother lived in and the delivery hospital defined closeness in space and the time between when the cases were born - seven, 14 and 21 days - defined closeness in time.The Knox test showed no indication of space-time clustering at the residential level, but clear indications at the hospital level in all the time windows: seven days (p=0.026), 14 days (p=0.010) and 21 days (p=0.004). Significant clustering at the hospital level was found from 1987-1997, but not 1998-2009. Kulldorff's scan statistic found seven significant clusters at the hospital level.Space-time clustering was found at the hospital but not residential level, suggesting a contagious environmental effect after delivery, but not in the prenatal period. The decrease in clustering over time may reflect improved routines to minimise the risk of contagion between patients receiving neonatal care. This article is protected by copyright. All rights reserved.

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