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. 1992 Apr;67(4 Spec No):432–435. doi: 10.1136/adc.67.4_spec_no.432

Risk factors for necrotising enterocolitis: the influence of gestational age.

P J Beeby 1, H Jeffery 1
PMCID: PMC1590486  PMID: 1586186

Abstract

Over a 7 year study period, 82 infants were identified who had necrotising enterocolitis (NEC). A case-control study of the 74 preterm infants was performed to determine those factors which contributed to the development of NEC. The 35 infants with NEC and gestation between 30-36 weeks, when compared with control infants matched for gestational age, had significantly lower birthweight centiles, cord pH, and 1 minute Apgar scores. By contrast, there were no significant differences between the 39 infants with NEC and controls in the 25-29 week group, except that fewer babies with NEC had received breast milk. The eight term babies all appeared to have an obvious predisposing event. We thus propose a model in which susceptibility to NEC is dependent on gestational age. In the 25-29 week range all babies are at risk on the basis of extreme prematurity. In the 30-36 week range asphyxiated and growth retarded babies are at increased risk, while at term a major predisposing event appears to be required.

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Selected References

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  1. Bunton G. L., Durbin G. M., McIntosh N., Shaw D. G., Taghizadeh A., Reynolds E. O., Rivers R. P., Urman G. Necrotizing enterocolitis. Controlled study of 3 years' experience in a neonatal intensive care unit. Arch Dis Child. 1977 Oct;52(10):772–777. doi: 10.1136/adc.52.10.772. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Clark D. A., Miller M. J. Intraluminal pathogenesis of necrotizing enterocolitis. J Pediatr. 1990 Jul;117(1 Pt 2):S64–S67. doi: 10.1016/s0022-3476(05)81133-3. [DOI] [PubMed] [Google Scholar]
  3. Covert R. F., Neu J., Elliott M. J., Rea J. L., Gimotty P. A. Factors associated with age of onset of necrotizing enterocolitis. Am J Perinatol. 1989 Oct;6(4):455–460. doi: 10.1055/s-2007-999639. [DOI] [PubMed] [Google Scholar]
  4. De Curtis M., Paone C., Vetrano G., Romano G., Paludetto R., Ciccimarra F. A case control study of necrotizing enterocolitis occurring over 8 years in a neonatal intensive care unit. Eur J Pediatr. 1987 Jul;146(4):398–400. doi: 10.1007/BF00444947. [DOI] [PubMed] [Google Scholar]
  5. Eibl M. M., Wolf H. M., Fürnkranz H., Rosenkranz A. Prevention of necrotizing enterocolitis in low-birth-weight infants by IgA-IgG feeding. N Engl J Med. 1988 Jul 7;319(1):1–7. doi: 10.1056/NEJM198807073190101. [DOI] [PubMed] [Google Scholar]
  6. Hackett G. A., Campbell S., Gamsu H., Cohen-Overbeek T., Pearce J. M. Doppler studies in the growth retarded fetus and prediction of neonatal necrotising enterocolitis, haemorrhage, and neonatal morbidity. Br Med J (Clin Res Ed) 1987 Jan 3;294(6563):13–16. doi: 10.1136/bmj.294.6563.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hakanson D. O., Oh W. Necrotizing enterocolitis and hyperviscosity in the newborn infant. J Pediatr. 1977 Mar;90(3):458–461. doi: 10.1016/s0022-3476(77)80716-6. [DOI] [PubMed] [Google Scholar]
  8. Kanto W. P., Jr, Wilson R., Breart G. L., Zierler S., Purohit D. M., Peckham G. J., Ellison R. C. Perinatal events and necrotizing enterocolitis in premature infants. Am J Dis Child. 1987 Feb;141(2):167–169. doi: 10.1001/archpedi.1987.04460020057026. [DOI] [PubMed] [Google Scholar]
  9. Kliegman R. M., Fanaroff A. A. Neonatal necrotizing enterocolitis: a nine-year experience. Am J Dis Child. 1981 Jul;135(7):603–607. doi: 10.1001/archpedi.1981.02130310009005. [DOI] [PubMed] [Google Scholar]
  10. Kliegman R. M., Hack M., Jones P., Fanaroff A. A. Epidemiologic study of necrotizing enterocolitis among low-birth-weight infants. Absence of identifiable risk factors. J Pediatr. 1982 Mar;100(3):440–444. doi: 10.1016/s0022-3476(82)80456-3. [DOI] [PubMed] [Google Scholar]
  11. Kliegman R. M., Pittard W. B., Fanaroff A. A. Necrotizing enterocolitis in neonates fed human milk. J Pediatr. 1979 Sep;95(3):450–453. doi: 10.1016/s0022-3476(79)80534-x. [DOI] [PubMed] [Google Scholar]
  12. Lucas A., Cole T. J. Breast milk and neonatal necrotising enterocolitis. Lancet. 1990 Dec 22;336(8730):1519–1523. doi: 10.1016/0140-6736(90)93304-8. [DOI] [PubMed] [Google Scholar]
  13. Malcolm G., Ellwood D., Devonald K., Beilby R., Henderson-Smart D. Absent or reversed end diastolic flow velocity in the umbilical artery and necrotising enterocolitis. Arch Dis Child. 1991 Jul;66(7 Spec No):805–807. doi: 10.1136/adc.66.7_spec_no.805. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Moriartey R. R., Finer N. N., Cox S. F., Phillips H. J., Theman A., Stewart A. R., Ulan O. A. Necrotizing enterocolitis and human milk. J Pediatr. 1979 Feb;94(2):295–296. doi: 10.1016/s0022-3476(79)80848-3. [DOI] [PubMed] [Google Scholar]
  15. Palmer S. R., Thomas S. J., Cooke R. W., Low D. C., Fysh W. J., Murphy J. F., Gandy G. M., Gamsu H. R. Birthweight-specific risk factors for necrotising enterocolitis. J Epidemiol Community Health. 1987 Sep;41(3):210–214. doi: 10.1136/jech.41.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Polin R. A., Pollack P. F., Barlow B., Wigger H. J., Slovis T. L., Santulli T. V., Heird W. C. Necrotizing enterocolitis in term infants. J Pediatr. 1976 Sep;89(3):460–462. doi: 10.1016/s0022-3476(76)80551-3. [DOI] [PubMed] [Google Scholar]
  17. Smith M. F., Borriello S. P., Clayden G. S., Casewell M. W. Clinical and bacteriological findings in necrotising enterocolitis: a controlled study. J Infect. 1980 Mar;2(1):23–31. doi: 10.1016/s0163-4453(80)91727-2. [DOI] [PubMed] [Google Scholar]
  18. Stoll B. J., Kanto W. P., Jr, Glass R. I., Nahmias A. J., Brann A. W., Jr Epidemiology of necrotizing enterocolitis: a case control study. J Pediatr. 1980 Mar;96(3 Pt 1):447–451. doi: 10.1016/s0022-3476(80)80696-2. [DOI] [PubMed] [Google Scholar]
  19. Vinocur P., Stine M. J. Risk factors for late-onset necrotizing enterocolitis. Indiana Med. 1990 Jul;83(7):478–480. [PubMed] [Google Scholar]
  20. Weinberg G., Kleinhaus S., Boley S. J. Idiopathic intestinal perforations in the newborn: an increasingly common entity. J Pediatr Surg. 1989 Oct;24(10):1007–1008. doi: 10.1016/s0022-3468(89)80203-9. [DOI] [PubMed] [Google Scholar]
  21. Wilson R., Kanto W. P., Jr, McCarthy B. J., Feldman R. A. Age at onset of necrotizing enterocolitis. Risk factors in small infants. Am J Dis Child. 1982 Sep;136(9):814–816. doi: 10.1001/archpedi.1982.03970450056013. [DOI] [PubMed] [Google Scholar]
  22. Wilson R., del Portillo M., Schmidt E., Feldman R. A., Kanto W. P., Jr Risk factors for necrotizing enterocolitis in infants weighing more than 2,000 grams at birth: a case-control study. Pediatrics. 1983 Jan;71(1):19–22. [PubMed] [Google Scholar]
  23. Yu V. Y., Joseph R., Bajuk B., Orgill A., Astbury J. Perinatal risk factors for necrotizing enterocolitis. Arch Dis Child. 1984 May;59(5):430–434. doi: 10.1136/adc.59.5.430. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Yu V. Y., Tudehope D. I., Gill G. J. Neonatal necrotizing enterocolitis: 1. Clinical aspects. Med J Aust. 1977 May 7;1(19):685–688. doi: 10.5694/j.1326-5377.1977.tb131028.x. [DOI] [PubMed] [Google Scholar]
  25. Yu V. Y., Tudehope D. I. Neonatal necrotizing enterocolitis: 2. Perinatal risk factors. Med J Aust. 1977 May 7;1(19):688–693. doi: 10.5694/j.1326-5377.1977.tb131029.x. [DOI] [PubMed] [Google Scholar]

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