Early versus late-onset necrotizing enterocolitis in very low birth infants in the neonatal intensive care unit
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In brief
In brief
This study compared early-onset versus late-onset necrotizing enterocolitis in 95 very low birth weight infants, finding that early-onset cases had higher rates of severe intraventricular hemorrhage and required surgery more frequently, while late-onset cases were associated with prior bloodstream infections.
Written by the GCMD Library team from the article.
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.