Risk factors for necrotising enterocolitis: the influence of gestational age.

Abstract

Over a 7 year study period, 82 infants were identified who had necrotising enterocolitis (NEC). A case-control study of the 74 preterm infants was performed to determine those factors which contributed to the development of NEC. The 35 infants with NEC and gestation between 30-36 weeks, when compared with control infants matched for gestational age, had significantly lower birthweight centiles, cord pH, and 1 minute Apgar scores. By contrast, there were no significant differences between the 39 infants with NEC and controls in the 25-29 week group, except that fewer babies with NEC had received breast milk. The eight term babies all appeared to have an obvious predisposing event. We thus propose a model in which susceptibility to NEC is dependent on gestational age. In the 25-29 week range all babies are at risk on the basis of extreme prematurity. In the 30-36 week range asphyxiated and growth retarded babies are at increased risk, while at term a major predisposing event appears to be required.

The Role of Intestinal Barrier Function in Early Life in the Development of Colitis

“…This includes: 1) an underdeveloped physical barrier with incomplete development of tight junctions; 2) a lack of proper chemical barrier due to lower gastric acid and mucin production, immature proteolytic enzyme activity (Udall, 1990), and deficiency of bacteriostatic proteins such as defensins (Salzman et al, 1998); and 3) a poor immunological barrier due to an under developed mucosal immune system. In addition, the peristaltic muscle contractions can also be abnormal in pre-term infants, which can lead to increased bacterial adhesion, that in turn allows for bacterial overgrowth that could increase endotoxin exposure and predispose to NEC (Beeby & Jeffery, 1992). Preterm infants have increased intestinal permeability and infants with NEC have even greater permeability (Neu, 2005).…”

Correlates of Lactation in Mothers of Very Low Birth Weight Infants

“…1 Described benefits for premature infants include prevention of infection, a reduction in the rate and severity of necrotizing enterocolitis and retinopathy of prematurity, and a possible beneficial effect on later intelligence. [1][2][3][4][5][6][7][8][9] Because of infant immaturity and/or neonatal morbidity, most mothers of very low birth weight infants (VLBW; Ͻ1500 g) need to express breast milk for weeks and sometimes months before their infant is able to nurse at the breast. The reported rates of successful lactation for mothers of preterm infants, especially VLBW infants, are low.…”

Faktor Risiko yang Memengaruhi Kolonisasi Mikroflora Saluran Cerna Neonatus Kurang Bulan dengan Enterokolitis Nekrotikans

“…Pada subjek tanpa NEC, Bifidobacterium species memiliki proporsi terbesar dengan rerata 29,5% (13,3%) dan jumlah absolut/100 mg tinja berkisar 5,4x10 4 hingga 4,3x10 6 . Mikroflora C. difficile memiliki proporsi paling sedikit dengan median 0,0% (0,0-0,0%) dan rentang jumlah absolut/100 mg tinja berkisar 0,2x10 2 -0,4x10 2 Jumlah mikroflora yang dinyatakan sebagai proporsi terhadap total mikroflora yang terdeteksi pada sampel tinja subjek NEC berdasarkan cara persalinan tertera pada Tabel 3. Uji statistik pada kelompok subjek NEC berdasarkan cara persalinan baik secara spontan maupun bedah kaisar tidak menunjukkan perbedaan proporsi mikroflora Bifidobacterium sp., K Pada penelitian kami, 15 subjek NEC merupakan bayi dengan berat lahir (1000-1499) gram, 5 (<1000), dan 10 (1500-1999).…”