Abstract
Background and aims Necrotizing enterocolitis (NEC) is the major disease of preterm newborns. The aim was to compare ‘classic-NEC’ (CNEC) vs. ‘transfusion-related-NEC’ (TNEC) in a tertiary neonatal intensive care unit in the USA (NICUM) and Poland (NICUP). Methods NEC cases from 2008–2012 in USA and from 2010–2012 in Poland underwent review. TNEC occurred at ≤48 h after blood transfusion. The health record categorised clinical, nutritional, laboratory, radiographic and pathologic features. Data analysis used SPSS software. Results Birth weight, gestational age and gender were the same in the two NICUs. Race was predominately Caucasian at both sites. Blood products and administration were similar for the NICUs. Modified Bell criteria for NEC at NICUM and NICUP averaged stage 2. The Table provides prevalence of CNEC and TNEC as well as other analysed variables. Conclusions TNEC, a disease seen in various settings, may be a pre-existing condition that blood transfusion unmasks. Chorioamnionitis without fetal infection may activate the immune system and reduce the time to NEC onset. A long period of ruptured membranes (ROM) may create persistent fetal inflammation. Early detection and interventions of fetal states increasing postnatal gut inflammation may be important in TNEC prevention.
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