Abstract
Necrotizing enterocolitis (NEC) is a serious disease of the intestinal tract affecting 5–10% of pre-term infants with up to 50% mortality in those that require surgery. There is wide variation in the rates and outcomes of NEC by race and ethnicity, and the reasons for this disparity are poorly understood. In this article, we review the epidemiology and discuss possible explanations for racial and ethnic differences in NEC. Most of the current evidence investigating the role of race in NEC comes from North America and suggests that Hispanic ethnicity and non-Hispanic Black race are associated with higher risk of NEC compared to non-Hispanic White populations. Differences in pre-term births, breastfeeding rates, and various sociodemographic factors does not fully account for the observed disparities in NEC incidence and outcomes. While genetic studies are beginning to identify candidate genes that may increase or decrease risk for NEC among racial populations, current data remain limited by small sample sizes and lack of validation. Complex interactions between social and biological determinants likely underly the differences in NEC outcomes among racial groups. Larger datasets with detailed social, phenotypic, and genotypic information, coupled with advanced bioinformatics techniques are needed to comprehensively understand racial disparities in NEC.
Highlights
Necrotizing enterocolitis (NEC) is a devastating inflammatory disease of the intestinal tract that affects 5–10% of pre-term infants born
In another small study, NEC rates were higher in non-Hispanic Black preterm infants, and correlated with higher prevalence of the NECassociated NFKB1 (g.-24519delATTG) variant in that race [60]
While socioeconomic differences between races account for a substantial portion of racial disparity in health outcomes [64], adjusting for socioeconomic differences does not completely eliminate racial disparities in NEC
Summary
Necrotizing enterocolitis (NEC) is a devastating inflammatory disease of the intestinal tract that affects 5–10% of pre-term infants born
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