Objective To study the influence of different feeding methods on clinical features and prognosis of term infants with necrotizing enterocolitis (NEC), in order to provide scientific reference for the treatment of NEC. Methods Clinical data of term infants with NEC in Beijing Children's Hospital from January 2016 to December 2020 was retrospectively analyzed.According to the feeding methods before the onset of the disease, the patients were divided into breastfeeding group, mixed feeding group and formula feeding group.The general situations, onset diseases, hospitalization process and disease outcomes were compared among the three groups, and the risk factors of poor prognosis were analyzed. Results A total of 275 full-term infants with NEC were enrolled in the study, including 69(25.1%) cases in breastfeeding group, 118(42.9%) cases in mixed feeding group and 88(32.0%) cases in formula feeding group.The median age of the onset of disease was 6 days old in the formula feeding group, earlier than breastfeeding and mixed feeding groups (H＝41.415, P<0.001).The proportions of NEC Ⅲ stage, elevated CRP level (χ2＝32.273), thrombocytopenia (χ2＝15.158), peritonitis and sepsis (χ2＝15.329) in formula feeding group were higher than those of the other two groups(P<0.05).The proportions of patients with respiratory failure, electrolyte disorder and shock were higher than those of mixed feeding group (P<0.05).The mortality rates of formula feeding group were higher than that of other two groups (89.8% vs.94.2%, 98.3%, χ2=7.137,P=0.028).Logistic regression analysis showed that full-term NEC combined with shock(OR=9.598, 95%CI:1.507 - 61.112), metabolic acidosis(OR=6.632, 95%CI:1.693 - 25.974) and NECⅢ stage(OR=17.180, 95%CI:1.402 - 210.524) were risk factors for poor prognosis of NEC (P<0.05). Conclusions Reasonable breastfeeding can delay the occurrence of full-term NEC.The NEC condition of term infants with formula feeding is poorer, mainly with more complications and worse prognosis.
Key words
enterocolitis necrotizing /
term infants /
feeding patterns
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