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Urinary Intestinal Fatty Acid Binding Protein for Diagnosis of Necrotizing Enterocolitis. OBJECTIVE: This study was conducted to compare the urinary levels of intestinal fatty acid binding protein (I-FABP) and I-FABP: Cr (creatinine) between neonates with necrotising enterocolitis and gestation matched healthy controls. METHODS: 24 neonates with stage 1, 25 with stage 2 and 3 necrotizing enterocolitis, and 25 gestation matched (32.9 wk) controls were compared. Single spot urine sample was collected for estimating the IFABP and creatinine levels. RESULTS: Median (IQR) value of urinary I-FABP were higher in those with stage 2, 3 NEC [2773 (2417.7- 2820)] than stage 1 NEC [1164 pg/mL (1341.5 - 2213.4)] and controls [413 (113 - 729.7); pg/mL] (P<0.001). Urinary I-FABP: Cr levels of 3.6 pg/mmoL had a sensitivity and specificity of 96% and 99.5%, respectively in diagnosing stage 2/3 NEC. CONCLUSION: Urinary IFABP: Creatine ratio of 3.6 pg/mmoL is highly specific for stage 2 and 3 NEC.