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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

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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.

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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).

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Authors and Affiliations

  1. Department of Neonatal Intensive Care Unit, Children’s Hospital of Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310053, China

    Huijia Lin, Liping Shi & Lizhong Du

  2. Department of Neurology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, 310053, China

    Shanshan Mao

  3. Department of Neonatal Surgery, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, 310053, China

    Jinfa Tou

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  1. Huijia Lin
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Correspondence to Lizhong Du.

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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.

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

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Lin, H., Mao, S., Shi, L. et al. 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. Pediatr Surg Int 34, 1201–1207 (2018). https://doi.org/10.1007/s00383-018-4339-9

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  • DOI: https://doi.org/10.1007/s00383-018-4339-9

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