Time to occurrence of necrotizing enterocolitis and its predictors among low birth weight neonates admitted at neonatal intensive care unit of felege hiwot compressive specialized hospital BahirDar, Ethiopia, 2021: A retrospective follow-up study

Abstract

BackgroundGlobally, the incidence of necrotizing enterocolitis (NEC) varies between 6 and 15% of all neonates admitted to the neonatal intensive care unit (NICU). Though necrotizing enterocolitis is a multifactorial and life-threatening disease, low birth prematurity is the single cause. Therefore, determining the time to presentation and its predictors of necrotizing enterocolitis were the main goals of this investigation.Materials and methodsAn institution-based retrospective follow-up study was conducted among 747 low birth weight (LBW) neonates admitted to the neonatal intensive care unit of Felege Hiwot comprehensive specialized Hospital from 1 January 2017 to 30 December 2019. The sample size was calculated by using the STATA package. Data were entered into Epi data version 3.1 and exported to STATA version 14 for analysis. The log-rank test and the Kaplan–Meier estimator were used to display the survival probability and differences between groups. At a significance threshold of 5%, Cox proportional hazard regression was performed to determine the net independent predictors of necrotizing enterocolitis.ResultThe overall incidence rate was 0.86 per 1,000 person-days (95% CI: 0.67, 1.14) with a 6.8% (95% i: 5.2, 8.9) proportion of necrotizing enterocolitis among low birth weight neonates. Preeclampsia [adjusted hazard ratio (AHR);1.92 (95% CI: 1.03–3.58)], premature rapture of membrane [AHR; 2.36 (95%, CI: 1.19–4.69)], perinatal asphyxia [AHR; 4.05 (95%, CI: 2.04–8.60)], gestational age between 28 and 32 weeks [AHR; 3.59 (95% CI: 1.01–8.83)], and birth weigh less than 1,000 g [AHR; 5.45 (95% CI: 3.84–9.12) were the independent predictors of necrotizing enterocolitis.ConclusionWithin the first 1–7 days of a newborn’s life, necrotizing enterocolitis was most common. It was discovered that preeclampsia, premature rupture of membrane, perinatal asphyxia, gestational age of 28–32 weeks, and birth weight less than 1,000 g were predictors of its occurrence.

Risk factors of necrotizing enterocolitis among neonates admitted to the neonatal intensive care unit at the selected public hospitals in southern Ethiopia, 2023

“…Neonates born with PROM were 3.51 times more likely to have necrotizing enterocolitis than neonates without PROM. This finding is consistent with the studies conducted in Ethiopia ( 37 ), China ( 38 ), Atlanta ( 47 ), and the Netherlands ( 40 ). The possible explanation could be that the fetus is more exposed to the bacteria in the vaginal canal as a result of the premature rupture of the membrane.…”

“…Necrotizing enterocolitis was 94% less likely in neonates delivered at full-term gestation than in newborns delivered during preterm gestation. This finding is supported by the studies conducted in Ethiopia (13,37), China (38), Korea (39), the Netherlands (40), Taiwan (41), Indonesia (42), and Canada (8). Because the intestines of a preterm newborn are not fully matured, they are more susceptible to infections and inflammation.…”

Enterocolitis Necrosante neonatal: Factores de riesgo y medidas de prevención

“…Ruptura prematura de membranas: Se ha demostrado que la corioamnionitis es un factor significativo en el desarrollo de ECN, tal y como se menciona en dos investigaciones realizadas en Etiopía [AOR: 6,09, (IC 95 % (1,31:28,26)], [AHR ; 2,36 (95 %, IC : 1,19-4,69)] y en un metaanálisis en donde los autores mencionan que la ruptura prematura de membranas aumenta las probabilidades de ECN entre los recién nacidos prematuros y con bajo peso al nacer (OR = 3,81, IC 95%: 1,16-12,52) (Su et al, 2023) (Temere et al, 2022)(Alene & et al, 2022.…”

Epidemiology of necrotizing enterocolities and its predictors among preterm newborns in Ethiopia: a systematic review protocol

“…In Ethiopia, the incidence of NEC ranged from 6.8-25.4% in pocket studies [5][6][7]. The most commonly identi ed predictors were gestational age [5,7], birth weight, preeclampsia [5][6][7], prolonged labor [5], APGAR score, chorioamnionitis, failure to breath, CPAP ventilation, mixed milk [5], length of hospital stay, initiating trophic feeding [6], premature rapture of membrane and perinatal asphyxia [7].…”