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Pediatric Surgery International

, Volume 34, Issue 11, pp 1201–1207 | Cite as

Clinical characteristic comparison of low birth weight and very low birth weight preterm infants with neonatal necrotizing enterocolitis: a single tertiary center experience from eastern China

  • Huijia Lin
  • Shanshan Mao
  • Liping Shi
  • Jinfa Tou
  • Lizhong Du
Original Article
  • 45 Downloads

Abstract

Purpose

This study aims to understand the clinical characteristics of preterm neonatal necrotizing enterocolitis (NEC) to improve the medical management level.

Methods

The clinical characteristics of preterm NEC infants with low birth weight (LBW, ≥ 1500 g) and very low birth weight (VLBW, < 1500 g) were compared. Then, clinical information, including demographics, surgical interventions and morbidity, were collected.

Results

A total of 149 preterm NEC infants (60 with VLBW and 89 with LBW) were enrolled. Their median birth weight and gestational age were 1600 g and 31 weeks, respectively. Respiratory support and surfactant therapy were more frequent in VLBW infants (90% vs. 38% and 75% vs. 21.3%) than in LBW infants. In addition, 70.5% of these infants were fed by formula before the NEC occurred. Prematurity-associated morbidities were significantly higher in VLBW infants. Furthermore, 12.8% of all NEC infants died at discharge, and mortality was more prevalent in VLBW infants (21.7% vs. 6.7%). The most frequently received surgeries were enterostomy (n = 58), primary anastomosis (n = 42), and peritoneal drainage (n = 2). Multifocal, localized and pan-intestinal disease occurred in 77.5%, 19.6% and three infants, respectively. Furthermore, postoperative complications occurred more frequently in VLBW infants.

Conclusion

The overall mortality was 12.8% for infants who had a larger mean gestational age and birth weight, when compared to that in developed countries. Higher rate of formula feeding might be an important risk factor for NEC development. Furthermore, mortality and morbidities, especially nutrition-associated complications, were more frequent in VLBW infants.

Keywords

Necrotizing enterocolitis Mortality Preterm Surgery 

Notes

Acknowledgements

The work performed by the authors is supported by the Zhejiang Medical and Health Science and Technology Project (no. 2017KY432 and no. 2017200317), and the Natural Science Foundation of Zhejiang Province of China (Grant no. LQ17H090004).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of the Children’s Hospital of Zhejiang University, School of Medicine. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments, or comparable ethical standards.

Informed consent

This retrospective de-identified study does not require individual informed consents.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Huijia Lin
    • 1
  • Shanshan Mao
    • 2
  • Liping Shi
    • 1
  • Jinfa Tou
    • 3
  • Lizhong Du
    • 1
  1. 1.Department of Neonatal Intensive Care UnitChildren’s Hospital of Zhejiang University School of MedicineHangzhouChina
  2. 2.Department of NeurologyChildren’s Hospital of Zhejiang University School of MedicineHangzhouChina
  3. 3.Department of Neonatal SurgeryChildren’s Hospital of Zhejiang University School of MedicineHangzhouChina

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