Huijia Lin1, Shanshan Mao2, Liping Shi1, Jinfa Tou3, Lizhong Du4. 1. Department of Neonatal Intensive Care Unit, Children's Hospital of Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310053, China. 2. Department of Neurology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, 310053, China. 3. Department of Neonatal Surgery, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, 310053, China. 4. Department of Neonatal Intensive Care Unit, Children's Hospital of Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310053, China. dulizhong@zju.edu.cn.
Abstract
PURPOSE: This study aims to understand the clinical characteristics of preterm neonatal necrotizing enterocolitis (NEC) to improve the medical management level. METHODS: The clinical characteristics of preterm NEC infants with low birth weight (LBW, ≥ 1500 g) and very low birth weight (VLBW, < 1500 g) were compared. Then, clinical information, including demographics, surgical interventions and morbidity, were collected. RESULTS: A total of 149 preterm NEC infants (60 with VLBW and 89 with LBW) were enrolled. Their median birth weight and gestational age were 1600 g and 31 weeks, respectively. Respiratory support and surfactant therapy were more frequent in VLBW infants (90% vs. 38% and 75% vs. 21.3%) than in LBW infants. In addition, 70.5% of these infants were fed by formula before the NEC occurred. Prematurity-associated morbidities were significantly higher in VLBW infants. Furthermore, 12.8% of all NEC infants died at discharge, and mortality was more prevalent in VLBW infants (21.7% vs. 6.7%). The most frequently received surgeries were enterostomy (n = 58), primary anastomosis (n = 42), and peritoneal drainage (n = 2). Multifocal, localized and pan-intestinal disease occurred in 77.5%, 19.6% and three infants, respectively. Furthermore, postoperative complications occurred more frequently in VLBW infants. CONCLUSION: The overall mortality was 12.8% for infants who had a larger mean gestational age and birth weight, when compared to that in developed countries. Higher rate of formula feeding might be an important risk factor for NEC development. Furthermore, mortality and morbidities, especially nutrition-associated complications, were more frequent in VLBW infants.
PURPOSE: This study aims to understand the clinical characteristics of preterm neonatal necrotizing enterocolitis (NEC) to improve the medical management level. METHODS: The clinical characteristics of preterm NEC infants with low birth weight (LBW, ≥ 1500 g) and very low birth weight (VLBW, < 1500 g) were compared. Then, clinical information, including demographics, surgical interventions and morbidity, were collected. RESULTS: A total of 149 preterm NEC infants (60 with VLBW and 89 with LBW) were enrolled. Their median birth weight and gestational age were 1600 g and 31 weeks, respectively. Respiratory support and surfactant therapy were more frequent in VLBW infants (90% vs. 38% and 75% vs. 21.3%) than in LBW infants. In addition, 70.5% of these infants were fed by formula before the NEC occurred. Prematurity-associated morbidities were significantly higher in VLBW infants. Furthermore, 12.8% of all NEC infants died at discharge, and mortality was more prevalent in VLBW infants (21.7% vs. 6.7%). The most frequently received surgeries were enterostomy (n = 58), primary anastomosis (n = 42), and peritoneal drainage (n = 2). Multifocal, localized and pan-intestinal disease occurred in 77.5%, 19.6% and three infants, respectively. Furthermore, postoperative complications occurred more frequently in VLBW infants. CONCLUSION: The overall mortality was 12.8% for infants who had a larger mean gestational age and birth weight, when compared to that in developed countries. Higher rate of formula feeding might be an important risk factor for NEC development. Furthermore, mortality and morbidities, especially nutrition-associated complications, were more frequent in VLBW infants.
Entities:
Keywords:
Mortality; Necrotizing enterocolitis; Preterm; Surgery
Authors: D J Andorsky; D P Lund; C W Lillehei; T Jaksic; J Dicanzio; D S Richardson; S B Collier; C Lo; C Duggan Journal: J Pediatr Date: 2001-07 Impact factor: 4.406
Authors: Charles R Hong; Brenna S Fullerton; Charles E Mercier; Kate A Morrow; Erika M Edwards; Karla R Ferrelli; Roger F Soll; Biren P Modi; Jeffrey D Horbar; Tom Jaksic Journal: J Pediatr Surg Date: 2018-03-08 Impact factor: 2.545
Authors: Naomi J Wright; Mandela Thyoka; Edward M Kiely; Agostino Pierro; Paolo De Coppi; Kate M K Cross; David D Drake; Mark J Peters; Joe I Curry Journal: J Pediatr Surg Date: 2014-02-10 Impact factor: 2.545
Authors: Miriam Duci; Francesco Fascetti-Leon; Marta Erculiani; Elena Priante; Maria Elena Cavicchiolo; Giovanna Verlato; Piergiorgio Gamba Journal: Pediatr Surg Int Date: 2018-04-11 Impact factor: 1.827