Necrotizing enterocolitis in multiple gestations: comparison with singletons
N Zampieri1, C Zamboni, F S Camoglio
1Department of Anesthetic and Surgical Sciences, Pediatric Surgical Unit, University of Verona, Verona, Italy. dr.zampieri@libero.it
Aim:
The purpose of this study is to describe the incidence of necrotising enterocolitis in multiple pregnancies and compare it with single pregnancies, pinpointing any risk and morbidity factors.
Methods:
A retrospective study of patients admitted to the neonatal pathology department of our hospital was carried out. The period considered was January 2002 to January 2009. All clinical records of patients who have developed NEC or suspected NEC were reviewed. Inclusion criteria were created. Risk factors and any other contributing causes in the two main groups (with and without NEC) were analysed.
Results:
During the study period we considered 409 babies born from multiple pregnancies and 895 from single pregnancies. Ninety-three from multiple pregnancies and 241 from single pregnancies were considered suitable for the study. The percentage of NEC in multiple pregnancies (18%) was higher than in the singles (4%) (P<0.05). The patients with suspected NEC or advanced NEC showed a longer time between birth and the first meconium discharge (5 vs. 2 days, P<0.05). The patients who received intestinal washing from the second day did not develop NEC (<0.05). Mortality was associated with the lower gestational age and a low Apger score at the first minute (P<0.05).
Conclusion:
Analysis shows that the incidence of NEC is higher in multiple pregnancies only if we consider gestational age or in association with severe prematurity. A gestational age <28 weeks and a low Apgar score at the first minute are risk factors for both categories.
