Risk factors for necrotizing enterocolitis in preterm infants: a 1:1 matched case-control study

Area of Science:

• Neonatalogy
• Pediatric Surgery
• Clinical Medicine

Background:

• Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in preterm infants.
• Identifying independent clinical risk factors for NEC is crucial for early screening and developing targeted prevention strategies.

Purpose of the Study:

• To identify independent clinical risk factors for NEC in preterm infants.
• To develop a prediction model for early NEC screening.

Main Methods:

• A 1:1 matched case-control study involving 172 preterm infants with NEC and 172 controls.
• Logistic regression analysis was used to identify independent risk factors.
• A prediction model was developed and validated using ROC curve analysis.

Main Results:

• Neonatal sepsis, blood transfusion, combined antibiotic use, neonatal asphyxia, and maternal gestational diabetes (GDM) were identified as independent risk factors for NEC.
• The prediction model demonstrated high accuracy with an AUC of 0.937.
• The model achieved a sensitivity of 93.8% and specificity of 79.5%.

Conclusions:

• Sepsis, blood transfusion, combined antibiotics, asphyxia, and maternal GDM are key independent predictors of NEC.
• Enhanced antibiotic stewardship and rigorous maternal GDM management are essential for reducing NEC incidence.
• The developed prediction model can aid in early screening and management of high-risk preterm infants.