1465 Age at Onset for Necrotizing Enterocolitis (Nec): Epidemiologic and Clinical Analysis

Epidemiology of Necrotizing Enterocolitis

“…A sharp decrease in the attack rate for NEC occurred at 35 to 36 weeks postconceptual age. 76 These data support the hypothesis that the risk of NEC is determined by maturity of the gastrointestinal tract. Palmer et al 51 studied100 newborn units in the United Kingdom and Ireland during a 4-year period.…”

Necrotizing Enterocolitis

“…Although occasionally occurring in term infants and sick preterm infants who are not on enteral feeding and on ventilatory support, many cases of NEC occur in premature infants receiving intermediate or stepdown neonatal intensive care.29,112 Extremely premature infants (< 28 weeks' gestation) are at risk for the development of NEC for a protracted period. The risk is high until the infant has achieved a postconceptual age of 35 to 36 weeks and sometimes later depending on coincident gastrointestinal problems.1z6, 127 The current thinking about the pathophysiology of NEC is based on epidemiologic studies from which several important risk factors have been dissected. The putative risk factors that predominate are prematurity, aggressive enteral feedings, infectious agents, and hypoxicischemic insults.…”

Superior mesenteric artery blood flow velocity in necrotising enterocolitis.

“…7 It has also been proposed that mucosal immaturity alone may be the most important factor in its aetiology. 13 14 The fact that necrotising enterocolitis is rare in the absence of enteral feeding demonstrates the importance of intraluminal factors. Breast milk exerts a protective effect whereas hyperosmolar feeds,2 or hyperosmolar drugs such as high doses of vitamin E,'5 may be risk factors.…”