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Risk factors for necrotizing enterocolitis in preterm infants: a Meta analysis
Chun-Yun Lu1, Ke-Feng Liu1, Gao-Xing Qiao1
1Department of Pharmacy, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Summary
Necrotizing enterocolitis (NEC) risk factors in preterm infants include maternal gestational diabetes, sepsis, and congenital heart disease. Protective factors against NEC are cesarean section, pulmonary surfactant, and breastfeeding.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in preterm infants.
- Identifying risk factors is crucial for prevention and management strategies.
Purpose of the Study:
- To systematically evaluate risk factors associated with NEC in preterm infants.
- To synthesize evidence from case-control and cohort studies through meta-analysis.
Main Methods:
- Comprehensive literature search across major databases (PubMed, Embase, Cochrane, CNKI, Wanfang) up to December 2021.
- Inclusion of 38 studies (28 case-control, 10 cohort) focusing on NEC risk factors in preterm neonates.
- Meta-analysis performed using RevMan 5.3 software to determine odds ratios and statistical significance.
Main Results:
- Maternal gestational diabetes (OR=2.96), intrahepatic cholestasis (OR=2.53), preeclampsia (OR=1.73), neonatal asphyxia (OR=2.13), low gestational age (OR=1.23), sepsis (OR=5.32), patent ductus arteriosus (OR=1.57), and congenital heart disease (OR=3.78) significantly increased NEC risk.
- Mechanical ventilation (OR=2.23), antibiotic use (OR=1.07), vasopressor use (OR=2.34), and fasting (OR=1.08) were also identified as risk factors.
- Cesarean section (OR=0.73), pulmonary surfactant use (OR=0.43), and breastfeeding (OR=0.24) demonstrated protective effects against NEC.
Conclusions:
- Several maternal and neonatal factors are significantly associated with increased NEC risk in preterm infants.
- Early identification and management of these risk factors, alongside promoting protective measures, are vital.
- Cesarean delivery, pulmonary surfactant administration, and breastfeeding appear to reduce the incidence of NEC in this vulnerable population.
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