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Related Experiment Videos

Necrotizing enterocolitis in full-term infants.

Daniel J Ostlie1, Troy L Spilde, Shawn D St Peter

  • 1Department of Surgery, The Children's Mercy Hospital, Kansas City, MO 64108, USA.

Journal of Pediatric Surgery
|July 16, 2003
PubMed
Summary
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Necrotizing enterocolitis (NEC) in full-term infants presents differently than in preterm infants, often diagnosed earlier and linked to cardiac disease. Outcomes for full-term infants with NEC are similar to preterm infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is predominantly a disease of prematurity, but affects full-term infants in about 10% of cases.
  • Previous research on NEC in full-term (FT) versus preterm (PT) infants has yielded conflicting findings.
  • Identifying factors specific to NEC in full-term neonates is crucial for understanding and managing this condition.

Purpose of the Study:

  • To review necrotizing enterocolitis (NEC) cases over three decades at a single institution.
  • To identify demographic, clinical, and outcome-related factors associated with NEC in full-term (FT) neonates.
  • To compare NEC characteristics and outcomes between full-term (FT) and preterm (PT) infants.

Main Methods:

  • Retrospective chart review of all infants diagnosed with definitive NEC from 1972 to 2001.

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  • Study included 277 infants: 251 preterm (PT) and 26 full-term (FT).
  • Collected data on demographics, clinical presentation, management, outcomes, and predisposing factors for comparison between FT and PT groups.
  • Main Results:

    • Full-term (FT) infants were diagnosed with NEC at a younger age (5 days) compared to preterm (PT) infants (13 days).
    • Enteral nutrition was initiated earlier in FT infants (1.6 days vs. 3.1 days).
    • Cardiac disease was a significantly more common predisposing factor in FT infants (23% vs. 10%), and 62% of FT infants had predisposing factors.

    Conclusions:

    • Full-term (FT) infants with NEC exhibit distinct characteristics compared to preterm (PT) infants, including earlier diagnosis and a higher association with cardiac disease.
    • Earlier feeding initiation in FT infants may correlate with an earlier onset of NEC.
    • The study found no significant difference in survival rates between FT and PT infants with NEC, contrary to some previous reports.