Necrotizing enterocolitis: clinical characteristics and outcome of a cohort of 106 cases at a children’s hospital in North China

Authors

Keywords:

formula feeding, necrotizing enterocolitis (NEC), neonatal intensive care unit, premature rupture of membrane

Abstract

Introduction: Necrotizing enterocolitis (NEC) in neonates, especially in the preterm, is a life-threatening condition. This study aims to analyze the clinical profile of NEC to get an insight for better understanding and management.

 Method: This was a retrospective analysis of neonatal NEC during the six-year period from 2014 to 2019. The prevalence and time for the development of NEC, clinical profile (term and preterm, low birth weight, gender, breast and formula feeding, abdominal distension, vomiting, hematochezia, apnea, fever, altered mental status, blood transfusion, breast or formula-fed, intestinal perforation, Bell’s stage and time for the development of NEC) and maternal factors (gestational hypertension, diabetes, premature rupture of membranes PROM, intrauterine fetal distress, placenta previa) were analyzed. Features in preterm and term neonates were compared. Ethical approval was obtained.

 Result: There were 106 NEC (0.87% of 12,184 neonatal admissions), 62 (58.49%) male, 90 (84.91%) preterm, and 85 (80.19%) LBW. Overall, 88 (83.02%) were Bell’s stage II, and severe stage III was seen in eight (19.04%) out of 42 babies with formula feeding as compared to one (1.56%) out of 64 in breastfeeding. The median time for the development of NEC was 6 days of life. The yearly prevalence of NEC per thousand neonates admitted during 6-years increased from 2.90 in 2014 to 12.06 in 2019. Overall mortality was 14 (13.20%).

 Conclusion: The yearly incidence of NEC increased with a higher incidence in preterm, in low birth weight and formula-fed neonates.

Author Biographies

Li Hui Rong, Yulin Children's Hospital, Xi’an Shanxi, China

Neonatology, Yulin Children's Hospital, Xi’an Shanxi, China

Si Xi Yao, Yulin Children's Hospital, Xi’an Shanxi, China

Neonatology, Yulin Children's Hospital, Xi’an Shanxi, China

Jay Narayan Shah, Patan Academy of Health Sciences

Professor, Department of Surgery, Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal; Visiting Professor, Medical College of Xi’an Jiaotong University, Xi’an Shanxi, China

Jiao Fu Yong, Children's Hospital of Shaanxi Provincial People's Hospital, Xi’an Shanxi, China

Visiting Professor, Children's Hospital of Shaanxi Provincial People's Hospital, 3rd Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an Shanxi, China

DOI: https://doi.org/10.3126/jpahs.v7i2.31125

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Published

2020-09-15

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Section

General Section - Original Articles