An epidemiological study of neonatal necrotizing enterocolitis

Area of Science:

• Neonatalogy
• Pediatric Gastroenterology
• Epidemiology

Background:

• Neonatal necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in newborns.
• Identifying epidemiological factors and risk in specific regions is crucial for targeted interventions.

Purpose of the Study:

• To investigate the epidemiology and associated risk factors of neonatal necrotizing enterocolitis in Kashmir.
• To analyze the incidence, clinical stages, and outcomes of NEC in a tertiary care hospital.

Main Methods:

• A retrospective hospital-based study evaluated 3235 neonates admitted to the Neonatal Intensive Care Unit (NICU).
• Forty-two neonates diagnosed with NEC (using clinical and radiological parameters, modified Bell's classification) were compared with 303 controls.
• Case records were reviewed for risk factors including hypothermia, respiratory distress, polycythemia, acidosis, sepsis, enteral feeding, and asphyxia.

Main Results:

• NEC incidence was 1% of NICU admissions and live births over 10 years.
• Eighty-one percent of NEC cases were preterm (<36 weeks gestation) and 81% had low birth weight (<2000 gms).
• Significant risk factors included hypothermia, respiratory distress, polycythemia, acidosis, sepsis, and asphyxia (P < 0.001). Mortality was 45% overall, increasing with NEC severity and inversely related to birth weight and gestational age.

Conclusions:

• Prematurity, low birth weight, hypothermia, and asphyxia are significant risk factors for NEC in Kashmir.
• Preventive strategies targeting these factors are essential to reduce NEC morbidity and mortality.
• Early recognition and management of NEC are critical, especially in preterm and low birth weight infants.