Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study

Abstract

Background: Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incidence, treatment, and mortality over the last decade in Spain. Methods:Multicenter cohort study with data from the Spanish Neonatal Network-SEN1500 database. The study period comprised from January 2005 to December 2017. Preterm infants <32 weeks of gestational age at birth without major congenital malformations were included for analysis. The main study outcomes were necrotizing enterocolitis incidence, co-morbidity (bronchopulmonary dysplasia, late-onset sepsis, cystic periventricular leukomalacia, retinopathy of prematurity, acute kidney injury), mortality, and surgical/non-surgical treatment.Results: Among the 25,821 included infants, NEC incidence was 8.8% during the whole study period and remained stable when comparing 4-year subperiods. However, more cases were surgically treated (from 48.

Ten-year trend of care practices, morbidities and survival of very preterm neonates in the Malaysian National Neonatal Registry: a retrospective cohort study

“… 27 28 However, since 2014 our LOS incidence had plateaued, and continued to be a significant predictor of mortality as reported elsewhere, 28 indicating more efforts are needed to reduce this problem. Although our NEC incidence had decreased to lower levels than the Spanish network, which reported a persistent incidence of 8.8% over 13 years, 29 it was higher than the Swiss network which maintained an incidence of 2.5% over 13 years. 5 Recently a UK centre 30 reported marked reduction in NEC incidence from 7.5% in 2008–2012 to 3.1% during 2013–2017 following introduction of probiotics.…”

Unraveling the Microbiome of Necrotizing Enterocolitis: Insights in Novel Microbial and Metabolomic Biomarkers

“…Necrotizing enterocolitis (NEC) is a harmful gastrointestinal disease commonly encountered in neonatal intensive care units (NICU) worldwide. Upon NEC occurrence, segments of the infant’s gastrointestinal tract undergo ischemia and subsequently necrosis, thus representing a gastrointestinal emergency in neonatal age, occurring in about 8% of premature infants with a reported mortality rate of up to 25% ( 1 ). NEC is believed to be a disease with a multifactor etiology whose precise cause has not been fully understood.…”

“…However, several risk factors have been identified. In particular, premature birth (less than 32 weeks of gestation) and very low birth weight (<1,500 g) have been reported to be among the main factors of increased risk of sepsis and NEC ( 1 , 2 ). In addition, NEC has long been linked to microbial dysbiosis of the infant gut ( 3 , 4 ).…”

Probiotics in the Prevention and Treatment of Necrotizing Enterocolitis

“…Prophylactic probiotics were implemented during the 12-year study period in some units, reaching 18.6% of the patients in 2015–2017. However, when all trials with different protocols and different strains were grouped together, the incidence of NEC remained stable despite the increase in protective factors [ 38 ].…”