Risk factors and severity indices in necrotizing enterocolitis

In retrospective analysis we set up a chart review of 61 consecutively newborn infants with proven diagnosis of necrotizing enterocolitis. The 26 female and 35 male infants were admitted to the intensive care unit of the Department of Pediatric Surgery from 1985 to 1991. Birth weights varied from 790 to 4680 g (mean value 2408 +/- 853), gestational ages from 27 to 43 weeks (mean value 36 +/- 4.0); 33 patients received conservative treatment and 28 patients were operated on. An analysis of operated (group 1) and conservatively (group 2) treated patients revealed no statistically significant difference in birth weight, gestational age, peripartal complications or type of feeding. Yet a few parameters measured at admission remained as severity indices. Operated babies had significantly higher counts of immature granulocytes and an elevation in the I:T-ratio, as well as lower counts of total granulocytes, lymphocytes, platelets and lower weights of the placenta. However, when taking into account the gestational age, the results showed that these parameters became insignificant in the low birthweight group below 34 weeks, and were of higher validity in the gestational age group over 35 weeks. In the latter group, C-reactive protein also proved to be a good parameter with statistical significance respecting the severity of necrotizing enterocolitis.