Decreasing Birth Weight May Predispose Premature Infants to Increased Mortality From Necrotizing Enterocolitis

Abstract

The objective of this study was to determine if there are any “risk factors” that could assist clinicians in identifying premature infants who are at greater risk for mortality when developing necrotizing enterocolitis (NEC). This was a retrospective study of infants admitted to the neonatal intensive care unit (NICU) at Children’s Hospital of Illinois, Peoria. Seventy-eight patients were diagnosed with NEC and were divided into 2 groups: NEC-survived versus NEC-died. Maternal risk factors, infant demographics, birth weight, incidence of sepsis, histamine-2 (H2) receptor blockers prescribed, temperature, anemia, and day of life when trophic feedings were begun and when enteral feedings were advanced were compared for significant differences. Univariate tests demonstrated that mothers of infants who died from NEC had a higher incidence of premature rupture of membranes. A premature infant’s decreasing birth weight significantly increased the risk for NEC-related mortality. Premature infants who received early trophic feedings had less NEC-related mortality, but this finding was not significant. Other conditions such as maternal risk factors, H2 blockers in total parenteral nutrition, enteral feedings, and temperature were not significant. Logistic regression indicated that a premature infant’s birth weight significantly increased his or her probability of dying from NEC while adjusting for other variables. A premature infant’s birth weight could be used by clinicians as a tool to identify patients at greater risk for NEC-related mortality. Although the true etiology of NEC remains unclear, early initiation of trophic feedings with colostrum may be the best defense for preventing the onset of this devastat- ing disease.