Necrotizing enterocolitis in full-term infants

Ostlie, Daniel J.; Spilde, Troy L.; Peter, Shawn D. St.; Sexton, Nick; Miller, Kelly A.; Sharp, Ronald J.; Gittes, George K.; Snyder, Charles L.

doi:10.1016/s0022-3468(03)00187-8

Cited by 180 publications

(101 citation statements)

References 18 publications

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“…This association appears in the great majority of previously published cases of NEC among term infants. [2][3][4][5][6][7][8][9][10][11][12][14][15][16] On the basis of the present and previous reports, we maintain that NEC in term neonates is a problem essentially limited to those that have some underlying illness or condition requiring NICU admission. If this is correct, the problem of preventing NEC in term infants may be less daunting than we initially anticipated.…”

Section: Discussionmentioning

confidence: 66%

“…6,10,14 Perhaps, the common feature of these predisposing features is reduced mesenteric perfusion. McElhinney et al…”

Section: Nec In Term Infantsmentioning

confidence: 99%

“…In fact, since 1973, published reports have described over 150 term and near-term neonates with NEC. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The prevalence of NEC among term neonates in the USA is not known, but Bolisetty et al 10 estimated that, in Australia, NEC occurs in one per 20 000 term births. As NEC is so rare among term neonates, it is challenging to develop and test prevention strategies.…”

Section: Introductionmentioning

confidence: 99%

“…We suspected that more cases of NEC in term infants would exist in the recent Intermountain Healthcare databases than in any of the published reports of this condition. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Our speculation was based on the fact that all but one of the previous reports of NEC in term neonates 10 were the experiences of individual hospitals. Thus, we undertook the present study, for two purposes; (1) to describe the cases of NEC of Bell's stage XII in term neonates cared for in the Intermountain Healthcare NICU system in recent years and (2) to contrast data from these patients with data from term neonates admitted to the same NICUs that did not develop NEC.…”

Section: Introductionmentioning

confidence: 99%

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Necrotizing enterocolitis in term neonates: data from a multihospital health-care system

et al. 2007

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Objective: In the past 5½ years, 30 term or near-term neonates in the Intermountain Healthcare system developed necrotizing enterocolitis (NEC) Bell's stage XII. We sought to identify possible explanations for why these patients developed NEC, by comparing them with 5847 others that did not develop NEC, from the same hospitals and of the same gestational ages, cared for during the same 5½-year period.Study design: Data were collected from neonates admitted to any of the Intermountain Healthcare NICUs with a birth date from 1 January 2001 to 30 June 2006, and a gestational age >36 weeks. A variety of patient features and feeding practices were compared between those that did vs did not develop NEC.Result: Forty-one neonates >36 weeks gestation were listed in the discharge records as having NEC of Bell's stage II or higher. However, on review of these 41 medical records, 11 were seen to have had NEC of Bell's stage I, whereas the remaining 30 had radiographs and clinical courses indicative of Bell's stage XII. Those 30 formed the basis of this study. Twenty-eight of the 30 developed NEC after having been admitted to an NICU for some other reason; the other two developed NEC at home, within 2 days of being discharged from an NICU. The 30 that developed NEC were more likely than the 5847 that did not develop NEC, to have congenital heart disease (P ¼ 0.000), polycythemia (P ¼ 0.002), earlyonset bacterial sepsis (P ¼ 0.004) or hypotension (P ¼ 0.017). All 30 received enteral feedings before NEC developed; 29 were fed either artificial formula or a mixture of formula and breast milk. The one that was exclusively fed human milk was fed human milk with added fortifier (24 cal/oz). The 30 that developed NEC were more likely to be fed formula exclusively (P ¼ 0.000). Seven of the 30 had a laparotomy for NEC; two of the seven had total bowel necrosis and support was withdrawn. The other five had perforations and bowel resections. The mortality rate was 13% (4/30). Conclusion:In our series, NEC among term or near-term neonates was exclusively a complication developing among patients already admitted to a NICU for some other reason. We speculate that the combination of reduced mesenteric perfusion and feeding with artificial formula were factors predisposing them to develop NEC.

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Section: Discussionmentioning

confidence: 66%

“…6,10,14 Perhaps, the common feature of these predisposing features is reduced mesenteric perfusion. McElhinney et al…”

Section: Nec In Term Infantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Necrotizing enterocolitis in term neonates: data from a multihospital health-care system

et al. 2007

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“…Prolonged rupture of the membranes, maternal infections, fetal distress, lower APGAR score, recurrent apneic episodes, hypotension, presence of intraumbilical vascular catheter, exchange transfusion, and PDA are some of the conditions leading to low-flow states and hypoxia. In full-term infants, NEC is seen considerably at an earlier stage, which is thought to be related to prematurely initiated formula feeding (2,4,5,(7)(8)(9)(10)(11)(12)(13)(14). As well as in our patient, a history of birth asphyxia secondary to prolonged labor and enteral feeding was elicited.…”

Section: Discussionmentioning

confidence: 99%

Neonatal colonic perforation

Saraç

Ataoğlu

Tatar

et al. 2015

UCD

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Neonatal colonic perforation is a rarely seen condition. Plain abdominal radiography of a 28-hour newborn consulted for vomiting and bloody stool revealed the presence of subdiaphragmatic free air, which necessitated surgical exploration. Transverse colonic perforation was detected during the exploration, and subsequently, a colostomy and appendectomy were performed. The postoperative follow-up period was uneventful. Necrotizing enterocolitis, Hirschsprung disease, and mechanical obstruction are some of the causes of colonic perforation during the neonatal period. Herein, we have shared a case of colonic perforation in an asphyctic newborn delivered after prolonged labor.

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Outcomes Analysis of Necrotizing Enterocolitis Within 11 958 Neonates Undergoing Cardiac Surgical Procedures

et al. 2010

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Through an analysis of 2 databases, we describe outcomes among 11 958 neonates with congenital heart disease undergoing cardiac procedures, with 194 developing necrotizing enterocolitis (NEC). Neonates with congestive heart failure or those undergoing systemic to pulmonary artery shunting were more likely to develop NEC, but these patients had inpatient mortality similar to that of their non-NEC counterparts.

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Necrotizing enterocolitis in full-term infants

Cited by 180 publications

References 18 publications

Necrotizing enterocolitis in term neonates: data from a multihospital health-care system

Necrotizing enterocolitis in term neonates: data from a multihospital health-care system

Neonatal colonic perforation

Outcomes Analysis of Necrotizing Enterocolitis Within 11 958 Neonates Undergoing Cardiac Surgical Procedures

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