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Published on: July 28, 2023
Epidemiology of necrotizing enterocolitis in preterm infants in China: A multicenter cohort study from 2015 to 2018
Xincheng Cao1, Lan Zhang1, Siyuan Jiang1
1Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Purpose:
To describe the current incidence, case-fatality rate and surgical treatment proportion of necrotizing enterocolitis (NEC) among preterm infants in China.
Methods:
The study included all live neonates with <34 weeks gestational age (GA) admitted to 25 tertiary hospitals within 7 days of birth from 19 provinces in China between May 2015 and April 2018. NEC was defined as ≥stage II according to Bell's criteria.
Results:
A total of 24,731 infants were included. The overall incidence of NEC was 3.3% and decreased with increasing GA and birth weight. The incidence of NEC was 4.8% in very preterm infants and 1.8% in infants born ≥32 weeks GA, respectively. The overall case-fatality rate of NEC was 9.5%, and the case-fatality rate was 7.0% among infants born ≥32 weeks GA. A total of 214 (27.9%) infants underwent surgery, and their overall case-fatality rate was 13.6%. Significant variation in the incidence of NEC existed among different centers (0.6-11.1%).
Conclusions:
The incidence and case-fatality rate of NEC are high in China, especially among infants with GA ≥32 weeks, and varies significantly among sites. A high proportion of NEC infants required surgical management, with an even higher case-fatality rate.
