Skip to main content

Advertisement

Log in

Risk Factors and Outcome in Neonatal Necrotising Enterocolitis

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To analyze multiple risk factors of necrotizing enterocolitis (NEC) and the outcome.

Methods

Hundred neonates with NEC were compared with 100 normal neonates matched for sex, gestation and weight. Their data including antenatal, natal, course of illness, hospital stay, progress and outcome were collected. Univariate analysis and logistic regression were used to analyze the risk factors.

Results

Mean age of onset of NEC was 2.35 ± 1.11 d. Stage I, II and III were noted in 48 %, 39 % and 13 % of cases respectively. Most common clinical features were abdominal distension (85 %) and feed intolerance (70 %). Important risk factors associated with NEC were sepsis, top feeding, perinatal asphyxia, respiratory distress and mechanical ventilation. Antenatal steroids and breast feeding had beneficial effect. No association was found with occurrence of NEC and cyanotic heart disease or administration of H2 blockers. Outcome in stage III was very poor.

Conclusions

Early identification of risk factors and appropriate intervention may reduce the incidence and improve the outcome in NEC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lin PW, Stoll BJ. Necrotising enterocolitis. Lancet. 2006;368:1271–83.

    Article  PubMed  Google Scholar 

  2. Neu J, Mshvildadze M, Mai V. A roadmap for understanding and preventing necrotizing enterocolitis. Curr Gastroenterol Rep. 2008;10:450–7.

    Article  PubMed  Google Scholar 

  3. Patole SK. Prevention and treatment of necrotizing enterocolitis in preterm neonates. Early Hum Dev. 2007;83:635–42.

    Article  CAS  PubMed  Google Scholar 

  4. Walsh MC, Kliegman RM, Fanaroff AA. Necrotizing enterocolitis: A practitioner’s perspective. Pediatr Rev. 1988;9:219–26.

    Article  CAS  PubMed  Google Scholar 

  5. Updegrove K. Necrotizing enterocolitis: The evidence for use of human milk in prevention and treatment. J Hum Lact. 2004;20:335–9.

    Article  PubMed  Google Scholar 

  6. Lin PW, Stoll BJ. Necrotising enterocolitis. Lancet. 2006;368:1271–83.

    Article  PubMed  Google Scholar 

  7. Narang A, Rao R, Bhakoo ON. Neonatal necrotizing enterocolitis an epidemiological study. Indian Pediatr. 1993;30:1207–14.

    CAS  PubMed  Google Scholar 

  8. Thomas C, Krishnan L. Neonatal necrotizing enterocolitis. Indian Pediatr. 1997;34:47–51.

    CAS  PubMed  Google Scholar 

  9. Kliegman RM, Fanaroff AA. Neonatal necrotizing enterocolitis: A nine year experience. Am J Dis Child. 1981;135:603–7.

    Article  CAS  PubMed  Google Scholar 

  10. Krediet TG, van Lelyveld N, Vijlbrief DC, Brouwers HA, Kramer WL, Fleer A, et al. Microbiological factors associated with neonatal necrotizing enterocolitis: Protective effect of early antibiotic treatment. Acta Paediatr. 2003;92:1180–82.

    Article  CAS  PubMed  Google Scholar 

  11. de la Cochetiere MF, Piloquet H, des Robert C, Darmaun D, Galmiche JP, Roze JC. Early intestinal bacterial colonization and necrotizing enterocolitis in premature infants: The putative role of Clostridium. Pediatr Res. 2004;56:366–70.

    Article  PubMed  Google Scholar 

  12. Kamitsuka MD, Horton MK, Williams MA. The incidence of necrotising enterocolitis after introducing standardized feeding schedules for infants between 1250 and 2500 grams and less than 35 weeks of gestation. Pediatrics. 2000;105:379–84.

    Article  CAS  PubMed  Google Scholar 

  13. Guthrie SO, Gordon PV, Thomas V, Thorp JA, Peabody J, Clark RH. Necrotizing enterocolitis among neonates in the United States. J Perinatol. 2003;23:278–85.

    Article  PubMed  Google Scholar 

  14. Caplan MS, Amer M, Jilling T. The role of human milk in necrotizing enterocolitis. Adv Exp Med Biol. 2002;503:83–90.

    Article  PubMed  Google Scholar 

  15. Hanson LA. Human milk and host defence: Immediate and long-term effects. Acta Paediatr Suppl. 1999;88:42–6.

    Article  CAS  Google Scholar 

  16. Nowicki PT, Nankervis CA. The role of the circulation in the pathogenesis of necrotizing enterocolitis. Clin Perinatol. 1994;21:219–34.

    CAS  PubMed  Google Scholar 

  17. Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med. 2011;364:255–64.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Nowicki PT. Ischemia and necrotizing enterocolitis: Where, when, and how. Semin Pediatr Surg. 2005;14:152–8.

    Article  PubMed  Google Scholar 

  19. Schnabl KL, Van Aerde JE, Thomson AB, Clandinin MT. Necrotizing enterocolitis: A multifactorial disease with no cure. World J Gastroenterol. 2008;14:2142–61.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Yost CC. Neonatal necrotizing enterocolitis: Diagnosis, management, and pathogenesis. J Infus Nurs. 2005;28:130–4.

    Article  PubMed  Google Scholar 

  21. Guthrie SO, Gordon PV, Thomas V, Thorp JA, Peabody J, Clark RH. Necrotizing enterocolitis among neonates in the United States. J Perinatol. 2003;23:278–85.

    Article  PubMed  Google Scholar 

  22. Ward RM, Beachy JC. Neonatal complications following preterm birth. BJOG. 2003;110:S8–16.

    Article  Google Scholar 

  23. Carter BM, Holditch-Davis D. Risk factors for necrotizing enterocolitis in preterm infants: How race, gender, and health status contribute. Adv Neonatal Care. 2008;8:285–90.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Dominguez KM, Moss RL. Necrotizing enterocolitis. Clin Perinatol. 2012;39:387–401.

    Article  PubMed  Google Scholar 

  25. Guillet R, Stoll BJ, Cotten CM, Gantz M, McDonald S, Poole WK, et al; National Institute of Child Health and Human Development Neonatal Research Network. Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2006;117:e137–42.

    Article  PubMed  Google Scholar 

  26. Luig M, Lui K; NSW & ACT NICUS Group. Epidemiology of necrotizing enterocolitis— Part II: Risks and susceptibility of premature infants during the surfactant era: A regional study. J Paediatr Child Health. 2005;41:174–9.

    Article  PubMed  Google Scholar 

Download references

Contributions

BG: Collected data and drafted the manuscript; BVB: Involved in the conception of the study and correction of the manuscript; BA, RJ, PP, PF and BS: Helped in data collection and reviewed the manuscript. BVB will act as guarantor for this paper.

Conflict of Interest

None.

Role of Funding Source

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Vishnu Bhat.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gane, B., Bhat, B.V., Adhisivam, B. et al. Risk Factors and Outcome in Neonatal Necrotising Enterocolitis. Indian J Pediatr 81, 425–428 (2014). https://doi.org/10.1007/s12098-013-1311-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-013-1311-5

Keywords

Navigation