Abstract
Aim: To compare the characteristic features of premature neonates who developednecrotizing enterocolitis (NEC)or notand review the risks for NEC in our neonatal intensive care unit. Materials and Method: Ninety four premature neonates with gestational age ≤ 35 weeks and/or birth weight ≤1500 g were included into the study. Characteristic features of the study neonates were compared. Results: NECoccurred in 15.9% of the study population . Seventy nine neonates who did not develop NEC and 15 neonates who developed stage II and III NEC were compared. The rate of intrauterine growth restriction (IUGR), late onset sepsis and therefore broad-spectrum antibiotic usage were significantly higher in the group who developed NEC. At the time of diagnosis 93 % of NEC positive patients were on full feeds either with breast milk only or breast milk + fortifier, none of them were formula fed, 7 % of the cases were never fed. Surgery was performed in all stage III NEC patients and overall mortality rate was 33%. Conclusion: Our findings suggest that together with exclusive breast feeding regimen, other strategies to prevent NEC should be implemented in this high risk preterm neonates.
Highlights
Gender, birth weight, 1st and 5th minute APGAR scores, resuscitation in the delivery room, the mode of delivery, presence of early and late onset sepsis, antibiotic therapy, antenatal steroid administration, maternal chorioamnionitis, intrauterine growth restriction (IUGR), type of feeding, presence of hemodynamically significant patent ductus arteriosus (PDA) and treatment with ibuprofen and long-term consequences of prematurity including retinopathy of prematurity (ROP), bronchopulmonary dyplasia (BPD) and periventricular leukomalacia (PVL) were all recorded for both necrotizing enterocolitis (NEC) negative and NEC positive infants
Fifty three % of neonates who developed NEC and 19% of neonates who did not had IUGR defined as below 10th percentilefor gestational age according to Fenton curves
NEC is a severe disease of gastrointestinal tract that often develops in the ileum but can involve any segment of the gastrointestinal tract
Summary
Risk factors associated with NEC are prematurity, low birth weight, formula feeding and alterations in bacterial colonization of the gastrointestinal tract (1,3). Ninety four premature neonates with gestational age ≤35 weeks and/or birth weight ≤ 1500g who were followed in NICU of Gazi University Hospital beyond 1st week of life between January 2011 and January 2015 were included in the study.
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