Importance of Combinations of Risk Factors in the Development of Necrotizing Enterocolitis in Newborn Children

Abstract

The purpose of the study was to identify factors of increased risk of necrotizing enterocolitis among young children in Baku. Materials and methods. Two observation groups were selected: the main observation group – children with necrotizing enterocolitis (128 children), the control observation group – healthy children (64 children). The children of the main group were divided into 2 groups: group 1 (n=83) – children with necrotizing enterocolitis who were treated conservatively and had no complications; group 2 (n=45) – children with necrotizing enterocolitis who had purulent-inflammatory complications and were treated surgically. In the course of the study, anamnestic and clinical laboratory research methods were used. Results and discussion. A relatively high percentage of women aged 19–29 years and 30–39 years was established – 63.2 ± 4.3 and 20.3 ± 3.5%, respectively, in the main group of children, and 75.0 ± 5.4 and 14.0 ± 4.3% in the control group. In families of children born with necrotizing enterocolitis, 38.3% of mothers assessed their material and living conditions as unsatisfactory (p<0.01). It was revealed that the proportion of children with postnatal risk factors: < 1500 g of body weight at birth among children of the main group (63.2 ± 4.3%) is by 5 times more than among children of the control group (12.5 ± 4.2%, p<0.05). It was also found that the proportion of children with respiratory disorders significantly differs from each other in the compared groups (22.6 ± 3.6 and 3.2 ± 2.1%, respectively, p<0.05). The proportion of children who were administered artificial enteral nutrition with milk formula among children of the main group (75.0 ± 3.8%) was by 9.6 times higher than among children of the control group (7.8 ± 3.3%, p<0.001). The results of our study also coincide with the results of the authors, who revealed a relationship with the course of pregnancy, childbirth, and necrotizing enterocolitis. Conclusion. The results of the study showed that the most pronounced risk of necrotizing enterocolitis incidence is expected at the birth of children weighing 1500 g or less (prematurity of degrees 3–4), and usually such children predominate among newborns whose mothers were not observed by obstetrician-gynecologists in the antenatal period and, therefore, did not receive adequate treatment. Background medical and biological factors can be called such as the age of the mother, the state of health of the woman (the presence of genital and extragenital diseases) and the course of pregnancy (gestosis in combination with various pathologies)