Necrotizing enterocolitis in term neonates: A different disease process?

Abstract:

INTRODUCTION:Necrotizing enterocolitis (NEC) has been a long-recognized complication of prematurity, but there is a paucity of studies on term infants. We sought to characterize the clinical presentation and outcomes of full term (FT) infants with NEC and compare these to our experience with preterm (PT) neonates. METHODS:We conducted a chart review of infants admitted to the NICU at University of Michigan with a diagnosis of NEC for over a 10-year period with a Modified Bell stage of 2 or greater. We compared the outcomes and comorbidities of PT against those of FT, defined as gestational age at birth below and above 37 weeks, respectively. RESULTS:Out of 170 infants, 28(17%) were FT. FT neonates were more likely to have undergone cardiac surgery for a congenital defect, excluding PDA ligation (64% vs. 8%)*. When compared to FT infants, PT infants were more likely to require surgical intervention (18% vs. 59%)*, have Bell stage 3 disease (82% vs. 43%)*, require vasopressor support (21% vs. 42%)+, and require ventilatory support (43% vs 75%)*. *p<0.01,+p<0.05. CONCLUSION:FT neonates present with different patterns of disease and have different outcomes, suggesting that this may be a different clinical entity than NEC in preterm infants. TYPE OF STUDY:Retrospective review LEVEL OF EVIDENCE: Level III.

journal_name

J Pediatr Surg

authors

Overman RE Jr,Criss CN,Gadepalli SK

doi

10.1016/j.jpedsurg.2019.02.046

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

1143-1146

issue

6

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(19)30187-3

journal_volume

54

pub_type

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