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Necrotizing enterocolitis in premature infants and newborns
M J Mϋller1, T Paul1, S Seeliger1,2
1Department of Pediatric Cardiology and Intensive Care Medicine, Medical Center Georg August University Göttingen, Germany.
Journal of Neonatal-Perinatal Medicine
|September 3, 2016
Summary
Necrotizing enterocolitis (NEC) is a severe intestinal disease in newborns. Early preventive measures like breastfeeding and probiotics may reduce NEC incidence and improve outcomes in premature infants.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Pediatric Surgery
Background:
- Necrotizing enterocolitis (NEC) is the most frequent acquired gastrointestinal disease in premature infants and newborns.
- It presents as an ulcerative inflammation of the intestinal wall with subtle clinical signs, ranging from localized symptoms to sepsis.
- NEC severity is classified using the modified Bell's Classification, guiding treatment from conservative management to surgical resection.
Purpose of the Study:
- To summarize the definition, classification, and treatment of Necrotizing Enterocolitis (NEC).
- To highlight the high mortality rates associated with NEC, particularly in extremely preterm infants.
- To outline key preventive strategies for NEC in vulnerable infant populations.
Main Methods:
- Review of existing literature on Necrotizing Enterocolitis (NEC).
- Analysis of clinical signs and diagnostic criteria for NEC.
- Evaluation of treatment modalities based on NEC severity.
- Assessment of preventive measures for NEC.
Main Results:
- NEC is a significant cause of morbidity and mortality in premature infants, with mortality reaching up to 42% in extremely small preterm infants.
- Clinical presentation of NEC can be non-specific, complicating early diagnosis.
- Treatment strategies vary widely based on disease severity, from non-surgical interventions to extensive bowel resection.
Conclusions:
- Effective prevention strategies for NEC are crucial, especially for high-risk infants.
- Early implementation of measures such as breastfeeding, donor human milk, probiotics, and judicious antibiotic use is recommended.
- Further research into optimal NEC prevention and management is warranted to reduce infant mortality and long-term complications.
