Early versus late-onset necrotizing enterocolitis in very low birth infants in the neonatal intensive care unit

Simona Yoffe Deri, Rimma Melamed, Kyla Marks, Yuval Mizrakli, Eugene Leibovitz, Agneta Golan, Eilon Shany

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Necrotizing enterocolitis (NEC), one of the most severe emergencies in neonates, is a multifactorial disease with diverse risk factors. Objectives: To compare between the clinical and laboratory characteristics of premature infants diagnosed with early-onset NEC (EO-NEC) and those with late-onset NEC (LO-NEC). Patients and methods: Enrolled infants were identified from prospective local data collected for the Israel National very low birth weight (VLBW, < 1500 g) infant database and from the local electronic patient files data base for the period 1996–2017. Results: Overall, 95 VLBW infants (61, 64.21% EO-NEC and 34, 35.87% LO-NEC) were enrolled. EO-NEC infants had higher rate of IVH grade 3 and 4 (26.2% vs 2.9%, p = 0.005) and were more likely to undergo surgery (49.2% vs 26.5%, p = 0.031). LO-NEC infants had a higher incidence of previous bloodstream infections (35.3% vs 8.2%, p = 0.002) compared to EO-NEC. In multivariable analysis models, surgical intervention was associated with EO-NEC (OR: 4.627, p = 0.013) as well as PDA and positive blood culture prior to the NEC episode. Conclusions: Our data support the hypothesis that EO-NEC has significant different clinical and microbiological attributes compared to LO-NEC.

Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalPediatric Surgery International
Volume38
Issue number2
DOIs
StatePublished - 1 Feb 2022

Keywords

  • Bacterial sepsis
  • Mortality
  • Prematurity

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