Risk Factors, Characteristics and Outcomes of Necrotizing Enterocolitis in Late Preterm and Term Infants

Objective: To identify the risk factors, characteristics and outcomes of necrotizing enterocolitis (NEC) at our institution.

Study Design: A retrospective case-control analysis of the charts of all late preterm and term infants, who had NEC of Bell's stage ≥ II from 1995 to 2009, along with infants of the same gestational age. Thirty-two late preterm infants had NEC meeting criteria and 128 late preterm and term infants were chosen as matched controls.

Results: The 32 NEC infants were more likely to have the following characteristics: a culture-proven sepsis (p = 0.0001), be small for their gestational age (p = 0.003), have a congenital heart disease (p = 0.007), and suffer from hypoxic- ischemic encephalopathy (p = 0.04). The presence of hypotension, metabolic acidosis, thrombocytopenia, and pneumoperitoneum was associated with a poor prognosis. Twelve of the 13 (92%) NEC infants who died had a surgical intervention.

Conclusion: In this study, late preterm and term infants who developed NEC had other underlying clinical diagnoses and had culture-proven sepsis. Mortality rate was high in infants who required surgical intervention, indicating that they were gravely ill from the onset. Thrombocytopenia, hypotension and metabolic acidosis in late preterm and term infant with NEC were associated with poor prognosis.