Necrotizing enterocolitis in premature infants at different gestation ages

Area of Science:

• Neonatology
• Pediatric Surgery
• Radiology

Background:

• Necrotizing enterocolitis (NEC) is a serious condition affecting preterm infants.
• Gestational age and intrauterine growth restriction (IUGR) are known risk factors for NEC.
• Radiographic signs of NEC can vary, but their correlation with specific patient subgroups requires further investigation.

Purpose of the Study:

• To compare the radiographic signs of NEC across different gestational age groups and body weight categories in preterm newborns.
• To identify distinct patterns of NEC presentation in relation to gestational age and the presence of IUGR.

Main Methods:

• Retrospective study of 52 preterm newborns diagnosed with NEC.
• Patients were categorized into three groups: very preterm newborns (VPN), moderately preterm newborns (MPN), and MPN with IUGR (MPN+IUGR).
• Analysis of NEC stages (Bell classification) and form (localized vs. diffuse) based on radiographic findings.

Main Results:

• Very preterm newborns (VPN) predominantly presented with NEC stage II and III, with a higher incidence of diffuse NEC compared to localized forms.
• Neonates with MPN+IUGR showed an equal distribution of NEC stage II and III, with diffuse NEC observed in 50% of cases.
• Moderately preterm newborns without IUGR (MPN) were diagnosed with earlier stages of NEC (I and II) and predominantly localized forms, with a significantly later onset of NEC compared to the MPN+IUGR group.

Conclusions:

• Distinct radiographic features of NEC were observed in moderately preterm newborns with IUGR.
• NEC in MPN+IUGR infants tends to have a more severe course and earlier onset compared to MPN without IUGR.
• Gestational age and IUGR significantly influence the presentation and severity of NEC in preterm infants.