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Necrotizing enterocolitis in a perinatal centre.

Abstract

Thirty-five neonates developed radiologically proven necrotizing enterocolitis (NEC) over a 40 month period. They were 28 +/- 2 weeks gestation, and weighted 1094 +/- 411 g at birth. Eighteen infants (51%) required surgery and three (8.5%) died. The incidence was 6.7% in the very low birthweight (VLBW) infants. A large proportion of NEC (60%) presented beyond 10 days of life. An inverse relationship between gestation and age of onset was observed. The age of presentation was 22 +/- 13 days (range 10-53 days) for the 18 infants less than or equal to 28 weeks compared with 7 +/- 5 days for those over 28 weeks (P less than 0.01). Five NEC infants had bacteraemia which occurred 2-7 days prior to gastrointestinal symptoms of NEC, and four were staphylococcal. Compared with infants controlled for gestation, there was no significant differences observed in perinatal events or feeding history. We concluded that an immature gastrointestinal system is vulnerable to NEC even beyond the early neonatal period.

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BibTeXRIS

K Lui, A Nair, W Giles, J Morris, E John. 1992. Necrotizing enterocolitis in a perinatal centre.. https://doi.org/10.1111/j.1440-1754.1992.tb02616.x

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Epidemiology and outcome of "early-onset" vs "late-onset" necrotizing enterocolitis.

OBJECTIVE: We hypothesized that among neonates with necrotizing enterocolitis (NEC), important epidemiologic and outcome differences exist between those with early-onset vs. those with late-onset NEC. METHODS: We reviewed all records of neonates cared for in the King Fahad University Hospital during the past ten years who had the diagnosis of NEC. We separated cases into two groups depending on age at diagnosis. Specifically, we termed "early-onset" those cases diagnosed during the first seven days of life, and "late-onset" those diagnosed thereafter. We compared, in the two groups, gestational age, clinical signs at onset, laboratory data, surgical findings, complications, and mortality. RESULTS: From 1989 to 1999, 37 cases of stage IIa (or higher) NEC were diagnosed; 25 "early-onset" and 12 "late-onset". Neonates with "early-onset" NEC were more mature (35.4 +/- 2.5 weeks gestation) than those with "late-onset" (27.7 +/- 2.8 weeks, P=0.0001), were more likely to have feedings begun in the first 48 hours of life (P = 0.0002), and more likely to have feeding increments of >25 ml/kg/day (P=0.03). Neonates with "late-onset" NEC were more likely to present with vomiting (P=0.003) and apnea (P=0.001), and were more likely to have ileal rather than colonic necrotic lesions, short bowel syndrome, and mortality (P=0.03). CONCLUSION: During the past 10 years at the King Fahad University Hospital, cases of early- and late-onset NEC have had distinct epidemiologic and outcome features. Recognizing these differences may be useful in prognostication and counseling.

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