Objective To explore the influence of feeding factors on the development of necrotizing enterocolitis (NEC) in preterm infants with gestational age less than 37 weeks, so as to provide reference for clinical management of NEC. Methods Preterm infants hospitalized in Neonatal Center of Beijing Children's Hospital from June 2019 to June 2021 were enrolled in this study. Infants with NEC were selected into the case group, meanwhile non-NEC infants matched by 1∶2 were selected as controls. The differences in feeding patterns (breast, mixed, formula feeding) and feeding factors (the onset time to enteral feeding after birth, fasting duration and parenteral feeding duration, etc.) were compared between the two groups of preterm infants, and the effects of these factors on the development of NEC were analyzed using univariate and multivariate Logistic analysis. Results There were 47 cases in the experimental group (30 cases in stage Ⅱ and 17 cases in stage Ⅲ), and 94 cases in the control group. There were no statistically significant differences in the general characteristics between the two groups (P＞0.05).Univariate analysis showed significant differences in the type of enteral feeding (χ2＝ 24.871), duration of fasting (Z＝-10.062), duration of parenteral feeding (Z＝-2.217) and the onset time to enteral feeding after birth (Z＝-15.772) in the two groups of preterm infants (P<0.01). Multifactorial Logistic regression analysis showed that breastfeeding was a protective factor for the development of NEC in preterm infants (P<0.01), prolonged fasting time (OR＝ 8.109, 95%CI:5.477 - 12.007), delayed enteral feeding after birth (OR＝ 17.710, 95%CI:11.748 - 26.699) were risk factors for the development of NEC in preterm infants (P<0.001). Conclusions Formula feeding and prolonged parenteral feeding are associated with the increased risk of NEC. Breastfeeding and enteral feeding early after birth may reduce the incidence of NEC in premature infants.
Key words
necrotizing enterocolitis /
preterm infants /
feeding
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