Epidemiological and clinical behavior of premature newborns with necrotizing enterocolitis. A 12- year retrospective study

Abstract

Introduction: Necrotizing enterocolitis (NEC) is the most common digestive system emergency in the neonatal period. The pathogenesis of NEC remains unknown, with prematurity being the main risk factor. Its diagnosis can be complex, causing mortality to remain high.

Objective: To understand the epidemiological and clinical behavior of premature newborns with necrotizing enterocolitis. A 12-year retrospective study.

Materials and Methods: Case-control study, a patient database was used from 2012 to 2023. The study populations were premature infants in the NICU with NEC diagnoses and controls were without NEC. Study population: Case-control.

Statistical analysis: Descriptive statistics were performed using frequency and percentage, means and standard deviation and median with interquartile ranges. A univariate and multivariate analysis was performed by logistic regression, with a p value <0.05. The analysis was performed in the SPSS vs 25 program.

Results: Total population n=5911, premature 261, 118 cases (45.2%) and 143 controls (54.8%). NEC IA (n=44) (16.9%), NEC IB (n=25) (9.6%), NEC IIA (n=33) (12.6%), IIB (n=10) (3.8%), NEC IIIA (n=3) (1.1%), NEC IIIB (n=3) (1.1%). A univariate risk analysis was performed with and without NEC, using 95% OR and a p value = <0.05. Statistical significance was found in DM, cesarean section, vaginal delivery, weight > 2000 g, sepsis, bacteremia, enteral nutrition (EN) 6-10 days, NICU stay 8-11, PCT >2 ng/dl, CRP >10, antibiotics, percutaneous catheters, umbilical catheters.

Conclusion: It was confirmed that the age of onset of symptoms, days of stay, method of birth, age of diagnosis, use of antibiotics, placement of central lines, markers of infection (PCT >2 ng/dl, CRP >3 mg/dl), diabetes mellitus in the mother, days of parenteral nutrition (TPN) are risk factors for presenting NEC. The results obtained provide new opportunities and research projects on this topic.