The predictors of necrotizing enterocolitis in newborns with low birth weight

Abstract

There are needs to investigate the influencing factors of necrotizing enterocolitis (NEC) in low birth weight (LBW) newborns, to provide insights into the clinical management of NEC.This study was a retrospective cohort study. Infants admitted to our hospital from January 1, 2019 to June 30, 2021 were selected. The clinical characteristics of NEC and no-NEC infants were evaluated. Logistic regression analyses were conducted to assess the risk factors of NEC in LBW infants.A total of 192 LBW infants were included, the incidence of NEC in LBW infants was 35.42%. There were significant differences in the congenital heart disease, sepsis, breastfeeding, blood transfusion and probiotics feeding between NEC and no-NEC group (all P < .05), and there were no significant differences in birth weight, gestational age, mother's pregnancy-induced hypertension, premature rupture of fetal membrane, amniotic fluid pollution, fetal asphyxia, neonatal respiratory distress syndrome and mechanical ventilation between NEC and no-NEC group (all P > .05). Congenital heart disease (OR: 2.128, 95% CI: 1.103–3.511), sepsis (OR: 1.630, 95% CI: 1.022–2.549), and blood transfusion (OR: 1.451, 95% CI: 1.014–2.085) were the independent risk factors for NEC in LBW infants, and breastfeeding (OR: 0.494, 95% CI: 0.023–0.928), probiotics feeding (OR: 0.816, 95% CI: 0.782–0.982) were the protective factors for the NEC in LBW infants. The prognosis of NEC infants undergone surgery treatment was better than that of infants undergone conservative treatments (P = .043).The incidence of NEC in LBW is high, which is affected by many factors, and comprehensive interventions targeted on the risk and protective factors should be made to improve the prognosis of LBW infants.

Association between glial fibrillary acidic protein, glial-derived neurotrophic factor, and fatty acid-binding protein-2 at birth in the incidence of necrotizing enterocolitis in preterm infants

“…This study reported that approximately 30% of very low birth weight infants experienced NEC, whereas the mortality rate for NEC was 22%. These results are consistent with those found in other studies ( 3 , 24 ), thus supporting the fact that NEC is still a threat to be aware of.…”

“…Based on our nutrition protocol, enteral nutrition was given using human milk or preterm formula if human milk was not available. However, previous studies have shown that exclusive breastfeeding is a protective factor against the occurrence of NEC (3,22). Most of the very low birth weight infants born in our hospital received enteral nutrition which was a combination of breast milk and premature formula because their mother was still critically ill.…”

“…It is estimated that each year, 15% of all deliveries are premature, and most preterm infant deaths are caused by complications of prematurity ( 1 , 2 ). Necrotizing enterocolitis (NEC) is an inflammatory-necrosis injury of the digestive tract that often occurs in preterm infants with high morbidity and mortality ( 3 ). Surgery is required in 40% of NEC cases, although the availability of pediatric surgeons may be limited in low-resource countries ( 4 ).…”

Factors influencing necrotizing enterocolitis in premature infants in China: a systematic review and meta-analysis

“…This meta-analysis showed that MSAF, history of antibiotic use and preterm infection were risk factors for NEC in preterm infants. Chen et al [ 45 , 54 , 63 ] also found that MSAF was an independent risk factor for NEC in preterm infants. The inhalation of amniotic fluid contaminated with meconium in utero in preterm infants can lead to the multiplication of intestinal pathogens and early infection [ 65 ].…”

Gut Microbiota and Immune System in Necrotizing Enterocolitis and Related Sepsis

“…Globally, the incidence of the disease reaches up to 13% of newborns at ≤33 weeks of gestation or babies with birth weights ≤2500 g and mortality rates between 30-50%. Finally, NEC occurs less often after ≥35 weeks of gestation [12][13][14]. Symptoms in premature infants and the time of onset, for the most part, are inversely proportional to gestational time (i.e., the earlier the newborn, the more obvious the signs).…”