Objective To investigate the clinical characteristics and risk factors of necrotizing enterocolitis (NEC) in very preterm infants, in order to provide reference for preventing NEC. Methods A retrospective case-control study was performed during January 2012 to November 2019 on 113 very preterm infants with NEC and 113 infants without NEC in the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University. The clinical characteristics of NEC in very premature infants were investigated and the risk factors of NEC were analyzed by Logistic regression. Results 1) NEC occurred at the age of [12.0 (5.0—22.5)] days old in very preterm infants. Infants with NEC stage Ⅲ had earlier onset age (Z=3.05,P=0.002), lower birth weight (t=2.46,P=0.015) and higher mortality (χ2=63.65,P＜0.001) compared with infants with NEC stage Ⅱ. 2) The clinical manifestations of very preterm infants with NEC were mainly abdominal distention, apnea, gross blood stool and emesis. Abdominal distention in infants with NEC stage Ⅲ were more severe than that with NEC stage Ⅱ(χ2=5.09,P=0.024). 3) The incidence of severe asphyxia, mechanical ventilation, grade III—IV RDS, sepsis and the proportion of boys in infants with NEC stage Ⅲ were higher than that with NEC stage Ⅱ(χ2=4.69, 8.51, 5.32, 3.89, 5.75, P＜0.05 or 0.01). Feeding rate and feeding amount in infants with NEC stage Ⅲ were significantly lower compared with infants with NEC stage Ⅱ(χ2=12.32, Z=3.93, P＜0.001). 4) Logistic regression analysis showed that male infants(OR=1.888, 95%CI: 1.019—3.499, P=0.043), sepsis(OR =6.866, 95%CI: 3.522—13.385, P＜0.001) and hypocalcemia (OR=2.684, 95%CI: 1.053—6.840,P=0.039) were risk factors for NEC in very premature infants, while breastfeeding(OR=0.318, 95%CI:0.108—0.933, P=0.037) was a protective factor. Conclusions The clinical manifestations of NEC in very premature infants vary with the severity of the disease. Early identification of high-risk premature infants should be strengthened in clinical practice, and preventive measures should be taken early to reduce the incidence of NEC.
Key words
very premature infants /
necrotizing enterocolitis /
sepsis /
risk factor
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