Maternal, neonatal, and nutritional risk factors for medical and surgical necrotizing enterocolitis

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2024年7月19日

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Clare Essex,
Clifford Hegedus,
Katherine Vincent,
Alanna Shiflett,
Allison Rohrer,
Katherine E. Chetta

摘要

Objective

To identify maternal and neonatal risk factors associated with progression to surgery or death after diagnosis of NEC.

Study design

Forty-seven demographic and clinical factors were evaluated across 216 validated cases of NEC occurring between 2010–2020. Nutrition at NEC onset was evaluated in 149 cases. The binary outcome of surgical NEC (progressing to surgery or death) vs. medical NEC (resolved with antibiotic/bowel rest) was compared across variables.

Results

Elevated CRP, rapidly decreasing platelet counts, inotropic medication, intubation, and positive blood cultures within 24 h of diagnosis were associated with progression to surgery/death. Infants with surgical NEC had higher abdominal circumferences at birth. Maternal milk intake and receipt of human milk fortifiers were associated with medical NEC, and infants receiving fortified, maternal milk showed the lowest progression to surgery/death.

Conclusion

The index of suspicion should be heightened for surgical NEC when these risk factors are present.