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Necrotizing enterocolitis: a comparison between full-term and pre-term neonates.

R Ruangtrakool1, M Laohapensang, C Sathornkich

  • 1Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|July 20, 2001
PubMed
Summary

Necrotizing enterocolitis (NEC) in full-term neonates shares risk factors with preterm infants but presents earlier. Surgical outcomes and complications were similar, though term infants showed better survival rates.

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Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Clinical research

Background:

  • Necrotizing enterocolitis (NEC) is a critical gastrointestinal condition primarily affecting premature infants.
  • While less common, NEC also occurs in full-term neonates, necessitating a comparative understanding of risk factors and outcomes.

Purpose of the Study:

  • To compare the clinical characteristics, risk factors, and surgical outcomes of NEC in full-term versus pre-term neonates.
  • To identify differences in presentation, operative management, and survival rates between these two groups.

Main Methods:

  • A retrospective study was conducted comparing 16 full-term and 18 pre-term neonates diagnosed with NEC and requiring surgery.
  • Data collected included risk factors, age at onset and operation, operative findings, and 3-month survival rates.

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Main Results:

  • Major risk factors for NEC in full-term infants included sepsis, small for gestational age (SGA), birth asphyxia, severe jaundice, and chorioamnionitis.
  • Full-term neonates developed NEC earlier (8.56 days) than pre-term neonates (12.78 days), but operative ages were similar.
  • The ileo-caecal region was the most common site of bowel necrosis in both groups. Clinical signs of peritonitis often guided surgery in full-term infants before pneumoperitoneum.
  • While 3-month survival was higher in term infants (75%) compared to pre-term infants (61%), surgical complication rates were comparable.

Conclusions:

  • Full-term neonates with NEC present with distinct risk factors and earlier onset compared to pre-term infants.
  • Despite differences in onset and some risk factors, surgical management and complication rates for NEC are similar across term and pre-term neonates.
  • Term infants with NEC demonstrate a better short-term survival rate, highlighting the importance of early diagnosis and intervention in this population.