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Updated: Jan 1, 2026
Author Spotlight: Enhancing Understanding and Treatment Strategies with the NEC-on-a-Chip Model
Published on: July 28, 2023
Mode of delivery and necrotizing enterocolitis in very preterm very-low-birth-weight infants
Arieh Riskin1,2, Shlomit Riskin-Mashiah2,3, Omer Itzchaki2
1Department of Neonatology, Bnai-Zion Medical Center, Haifa, Israel.
Objective:
To investigate the association between delivery mode and necrotizing enterocolitis (NEC) in very preterm (24-31 weeks' gestational age (GA)) very-low-birth-weight (VLBW) (≤1500 g) infants.
Design:
Population-based observational study using univariate and multivariable logistic regression analyses.
Setting:
The Israel National VLBW infant database 1995-2015.
Patients:
20,223 VLBW infants, 11,832 singletons and 8391 multiples.
Main Outcome Measures:
The association of NEC occurrence to delivery by cesarean section (CS) in singletons and multiples VLBW very preterm infants.
Results:
NEC occurred in 7.6% of singletons and 6.4% of multiples. 71.5% were delivered by CS (64.7% of singletons, 80.9% of multiples). CS delivery was not significantly associated with NEC stages 2-3 in singletons; but multiple births CS were associated with significantly higher odds for NEC (OR 1.31, 95% CI 1.01-1.69). Odds for NEC were greater with lower GA, small for GA (SGA) and patent ductus arteriosus (PDA) in both singletons and multiples, and lower in multiples with antenatal corticosteroids.
Conclusions:
We demonstrated association between deliveries by CS and increased risk for NEC only in multiple pregnancies.
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