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Necrotizing enterocolitis in multiple-birth infants.

R W Powell1, D L Dyess, A Luterman

  • 1University of South Alabama Medical Center, Mobile.

Journal of Pediatric Surgery
|March 1, 1990
PubMed
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Necrotizing enterocolitis (NEC) affects 3.8% of multiple-gestation infants. A low 1-minute Apgar score significantly predicts NEC development and surgical intervention needs in these vulnerable newborns.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Perinatology

Background:

  • Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition affecting premature and high-risk infants.
  • Multiple-gestation infants represent a vulnerable population with unique risk factors for neonatal diseases.
  • Understanding NEC incidence and predictors in this specific cohort is crucial for timely intervention.

Purpose of the Study:

  • To determine the incidence of NEC in infants born from multiple gestations admitted to a neonatal intensive care unit (NICU).
  • To identify significant risk factors, particularly the 1-minute Apgar score, associated with NEC development and surgical intervention in this population.
  • To analyze outcomes, including mortality and need for surgery, for multiple-gestation infants with NEC.

Main Methods:

Related Experiment Videos

  • A retrospective review of infants from multiple gestations admitted to the NICU over a 5-year period.
  • Calculation of NEC incidence based on diagnosed or suspected cases.
  • Statistical analysis to identify predictors of NEC and surgical intervention, comparing affected infants with unaffected siblings.

Main Results:

  • The incidence of NEC or suspected NEC in multiple-gestation infants was 3.8% (20 out of 532).
  • A 1-minute Apgar score below 6 was a significant predictor for NEC (P < .028) and surgical intervention (P < .020).
  • Infants with a 1-minute Apgar score < 6 had an 82% NEC rate, compared to 31% for those with a score > 6. Overall mortality was 15%.

Conclusions:

  • Multiple-gestation infants are at significant risk for NEC, with a notable incidence in the NICU population.
  • The 1-minute Apgar score is a critical early indicator for NEC risk and the potential need for surgical management in these infants.
  • Early identification of low Apgar scores in multiple-gestation neonates is vital for proactive monitoring and management of NEC.