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Necrotizing enterocolitis: a 15-year experience.

G M Leong, J H Drew

    The Australian & New Zealand Journal of Obstetrics & Gynaecology
    |February 1, 1987
    PubMed
    Summary
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    Necrotizing enterocolitis (NEC) affected 87 infants, with a 26.4% mortality rate. This study highlights an increasing incidence of NEC and identifies associated risk factors in mothers and infants, including low birth weight.

    Area of Science:

    • Neonatalogy
    • Pediatric Surgery
    • Obstetrics

    Background:

    • Necrotizing enterocolitis (NEC) is a significant cause of neonatal mortality.
    • Understanding NEC incidence and risk factors is crucial for improving infant outcomes.
    • Previous studies have indicated associations between NEC and prematurity, but further investigation into obstetric risk factors is warranted.

    Purpose of the Study:

    • To analyze the incidence, mortality, and risk factors associated with necrotizing enterocolitis (NEC) in infants over a 15-year period.
    • To identify maternal and infant characteristics that increase the risk of developing NEC.
    • To describe the treatment modalities and sequelae of NEC in a neonatal population.

    Main Methods:

    • Retrospective analysis of 87 infants diagnosed with NEC between 1971 and 1985 at Mercy Maternity Hospital, Melbourne.

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  • Data collection included infant birth weight, gestational age, maternal risk factors (gestational diabetes, pre-existing diabetes, estriol excretion), and treatment outcomes.
  • Statistical analysis was performed to determine incidence rates, mortality, and associations between risk factors and NEC development.
  • Main Results:

    • The incidence of NEC increased from 0.07% to 0.25% of livebirths during the study period.
    • A significant association was found between NEC and higher-risk obstetric populations, including gestational diabetes and subnormal estriol excretion.
    • Very low birth weight (VLBW) infants (<1500g) comprised 29.9% of NEC cases, with a mean age of onset of 9.9 days.
    • The overall mortality rate for NEC was 26.4%, contributing 2.6% to all neonatal deaths.
    • Colonic strictures, fistulas, and short-gut syndrome were observed sequelae in survivors.

    Conclusions:

    • The incidence of NEC is increasing, necessitating continued surveillance and research into preventative strategies.
    • Maternal risk factors, such as gestational diabetes, play a significant role in NEC development.
    • Early identification of high-risk infants and prompt medical or surgical intervention are essential for managing NEC and reducing mortality.