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A Neonatal BALB/c Mouse Model of Necrotizing Enterocolitis
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Risk Factors and Predictive Parameters of Necrotizing Enterocolitis in Preterm Infants-A Single-Center Retrospective

Tamas Toth1,2, Angela Borda3, Reka Borka-Balas4,5

  • 1Institution Organizing University Doctoral Studies (IOSUD), George Emil Palade University of Medicine Pharmacy Science and Technology of Targu Mures, 540142 Targu Mures, Romania.

Diseases (Basel, Switzerland)
|November 26, 2025
PubMed
Summary

Necrotizing enterocolitis (NEC) in preterm infants requiring surgery is linked to lower gestational age, birth weight, abdominal distension, and hyponatremia. Early surgical intervention may benefit selected infants, but further research is needed.

Keywords:
Bell stagelow birth weightnecrotizing enterocolitisprematurityrisk factorssurgery

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Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is a critical gastrointestinal emergency in premature infants.
  • Identifying predictors for surgical NEC and associated outcomes is crucial for timely intervention.

Purpose of the Study:

  • To identify risk factors and predictive parameters for NEC requiring surgery in preterm infants.
  • To evaluate the short-term outcomes of infants with surgically managed NEC.

Main Methods:

  • Retrospective study of preterm neonates diagnosed with NEC between January 2015 and May 2025.
  • Analysis of demographic data, perinatal factors, clinical presentation, imaging, and laboratory findings.
  • Focus on surgically managed NEC cases, employing descriptive and inferential statistics.

Main Results:

  • Eleven of 44 (25%) infants required surgery, with common signs including abdominal distension and bilious gastric residue.
  • Surgical NEC was associated with lower gestational age, lower birth weight, pneumoperitoneum, thrombocytopenia, elevated CRP/LDH, and hyponatremia.
  • Lower gestational age and birth weight correlated with higher NEC severity (Bell's stage). Overall mortality was 29.5%, with 9.1% surgical mortality.

Conclusions:

  • Low gestational age, low birth weight, abdominal distension, systemic inflammation, and hyponatremia are frequent in surgically treated NEC infants.
  • Early surgical intervention might be beneficial for selected NEC cases, even without perforation.
  • Further multi-center prospective studies are required to validate predictive markers and optimize surgical timing.