Risk Factors That May Predispose Premature Infants to Increased Incidence of Necrotizing Enterocolitis

Abstract

The objective of this study was to determine if there are any common “risk factors” that could assist clinicians in identifying premature infants who are at greater risk for developing necrotizing enterocolitis (NEC). This was a retrospective study of infants admitted to the neonatal intensive care unit at Children’s Hospital of Illinois, Peoria. In total, 384 charts were reviewed. Seventy-eight infants diagnosed with NEC were compared to 246 infants who did not have NEC. Maternal risk factors, infant demo-graphics, incidence of sepsis, H2 blockers prescribed, temperature, anemia, and day-of-life gut priming and enteral feedings were compared between the two groups for significant differences. Univariate tests and logistic regression demonstrated that mothers of infants who developed NEC had a higher incidence of premature rupture of membranes. Significantly more males developed NEC than females. African American infants had a higher incidence of developing NEC than white infants. Infants who developed NEC often had a prior diagnosis of sepsis and were prescribed H2 blockers more frequently. Infants who had early initiation of gut priming and earlier initiation of enteral feedings had significantly less incidence of NEC than infants whose gut priming and enteral feedings were delayed. This study supports that risk factors for NEC are multifactorial and could assist clinicians in identifying subgroups, within the neonatal population, that are at greater risk for this disease, leading to the implementation of strategies to reduce the onset of NEC. Unfortunately, the true etiology of NEC remains unclear.

Estimation of Neonatal Intestinal Perforation Associated with Necrotizing Enterocolitis by Machine Learning Reveals New Key Factors

“…We found that male gender was a highly predictive parameter for intestinal perforation associated with NEC compared to only NEC. There are only a few studies where male gender has been significantly associated to increased risk of NEC [ 36 , 38 ] or not [ 39 ]. Duci et al reported that gender was not statistically significant when comparing patients with NEC treated medically vs. NEC requiring surgery [ 39 , 40 ].…”

Predictive and diagnostic value of serum intestinal fatty acid binding protein in neonatal necrotizing enterocolitis (case series)

“…The incidence of NEC varies from 0.5 to 5 infants per 1000 live births with a mortality rate of 10–50% [10].…”

A critical analysis of risk factors for necrotizing enterocolitis

“…18 Prolonged rupture of membranes, a common antecedent to chorioamnionitis, has been associated with NEC across several studies spanning several decades. 19–21 While maternal infection may increase NEC risk for the infant, maternal antibiotic treatment does not appear to increase risk and may, in fact, decrease it. Data from a prospective, observational microbiome study found a reduced risk of NEC if maternal antibiotics were given (OR 0.28, 95% CI 0.14–0.56, 580 infants).…”