An update on necrotizing enterocolitis: pathogenesis and preventive strategies

Area of Science:

• Neonatal Medicine
• Gastroenterology
• Pediatric Surgery

Background:

• Necrotizing enterocolitis (NEC) is a critical condition affecting preterm infants, with significant morbidity and mortality.
• Infants surviving NEC often face long-term complications, including infections, growth failure, and developmental delays.
• Intestinal immaturity, both structural and immunological, is a primary factor in NEC pathogenesis.

Purpose of the Study:

• To review current preventive strategies for necrotizing enterocolitis in preterm infants.
• To evaluate the evidence supporting various interventions aimed at reducing NEC incidence and severity.
• To identify areas where further research is needed to establish effective NEC prevention.

Main Methods:

• Literature review of studies on NEC pathogenesis and prevention.
• Analysis of clinical practices and evidence for interventions like breastfeeding, probiotics, prebiotics, and nutritional supplements.
• Synthesis of findings regarding the efficacy of different preventive strategies.

Main Results:

• Breastfeeding and probiotics are effective preventive strategies for infants over 1,000g birth weight.
• Other strategies such as prebiotics, glutamine, arginine, and lactoferrin require further investigation.
• Multiple factors contribute to NEC, including bacterial colonization, ischemia, and genetic susceptibility.

Conclusions:

• Established preventive measures like breastfeeding and probiotics are crucial for high-risk infants.
• Further research is essential to validate the efficacy of emerging strategies for NEC prevention.
• A multifaceted approach considering various risk factors is necessary for managing NEC in preterm neonates.