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Modifiable Risk Factors in Necrotizing Enterocolitis

C Michael Cotten1

  • 1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Duke University School of Medicine, Box 2739 DUMC, Durham, NC 27710, USA.

Clinics in Perinatology
|February 18, 2019
PubMed

Insights

Necrotizing enterocolitis (NEC) incidence has decreased in preterm infants due to practice modifications. These changes, based on scientific evidence, aim to reduce NEC risk and associated morbidities.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Public Health

Background:

  • Multicenter studies show declining necrotizing enterocolitis (NEC) rates in preterm infants over 20 years.
  • This trend aligns with practice modifications implemented via quality-improvement initiatives.
  • Initiatives target reducing NEC specifically or overall mortality and morbidity in extremely premature infants.

Purpose of the Study:

  • To review recent practice modifications aimed at reducing NEC in preterm infants.
  • To discuss select modified and modifiable practices contributing to NEC reduction.

Main Methods:

  • Review of recent reports from centers modifying clinical practices.
  • Analysis of quality-improvement techniques and their impact on NEC incidence.
  • Synthesis of evidence from mechanistic studies, epidemiologic data, and clinical trials.

Main Results:

  • Significant reductions in NEC incidence reported by multicenter groups.
  • Practice modifications are associated with decreased NEC rates.
  • Quality-improvement strategies have shown efficacy in managing risks for extreme prematurity.

Conclusions:

  • Evidence-based practice modifications are effective in reducing NEC in preterm infants.
  • Continued focus on quality improvement is crucial for managing NEC and associated morbidities.
  • Further research into modifiable practices can optimize outcomes for extremely premature infants.

Keywords:
AntacidsAntibioticsBreastfeedingHuman milkNecrotizing enterocolitisQuality improvementTransfusions

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