Utility of Routine Hemoccult Testing in Prediction of Necrotizing Enterocolitis in Premature Neonates: Table 1.

Background: Necrotizing enterocolitis (NEC) is a common surgical disease in premature neonates, however, it may occasionally occur in term neonates. The etiology of NEC in prematurity is multifactorial but is still not well understood in term neonates. In this study, the maternal and neonatal risk factors, along with underlying pathology that may precipitate NEC in term neonates are investigated. Methods: A retrospective study investigating the maternal and neonatal risk factors for NEC in term neonates (G.A ≥37 weeks) was performed over an 8-years period (January 2009 to March 2017). We used the second group of healthy term neonates over the same period as a control group. The data were collected from medical records. Term babies with the primary diagnosis of NEC were included in the review. Premature neonates (G.A <37 weeks) and NEC secondary to intestinal obstruction (e.g. Hirschsprung’s disease) were excluded from the study. Results: Of 194 babies with NEC, 14 were term neonates. Maternal risk factors: maternal age, Rhesus status, nicotine use, medication use, chronic and gestational illness were not found to be significant, however, maternal methamphetamine (MA) abuse was found to be a significant risk factor. Neonatal risk factors: genetic disorder, mode of delivery, type of milk, and invasive procedure were not found to be significant, but the presence of congenital heart disease (CHD) was a significant risk factor. Three neonates with CHD (3/4) in the group of term neonates with NEC also had maternal MA use. Conclusion: NEC in term neonates is rarely encountered. CHD is well known to precipitate the disease in premature or full-term neonates, as also noted in this cohort. MA usage was also noted as a possible underlying cause.

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Effect of Feeding Strategies on the Development of Fulminant Necrotizing Enterocolitis

European Journal of Pediatric Surgery ◽

10.1055/s-0040-1715613 ◽

2020 ◽

Author(s):

Heather A. Hartman ◽

Christopher Pennell ◽

Stephen Aronoff ◽

L. Grier Arthur

Keyword(s):

Multivariate Analysis ◽

Breast Milk ◽

Necrotizing Enterocolitis ◽

Univariate Analysis ◽

Feeding Strategies ◽

Premature Neonates ◽

Caloric Density ◽

Increased Risk ◽

Full Volume ◽

Effect Of Feeding

Abstract Introduction Necrotizing enterocolitis (NEC) causes significant neonatal morbidity. A subset of infants experience precipitous decline and death from fulminant-NEC (F-NEC). We sought to determine the effect of feeding practices on the development of this more virulent form of NEC. Materials and Methods Premature neonates developing Bell's stage II or III NEC between May 2011 and June 2017 were reviewed. Infants were stratified as having NEC or F-NEC, defined as NEC-totalis or NEC causing rapid decline and death within 72 hours. Risk factors extracted included demographics, gestational age, and weight at NEC diagnosis. Feeding data extracted included age at first feed, caloric density, type of feed (breast milk or formula), and whether full volume feeds were reached. Univariate analysis and multivariate analysis were performed. Results A total of 98 patients were identified, of which 80 were included. In total, 57 patients had NEC and 23 had F-NEC. Reaching full volume feeds was associated with F-NEC on both univariate and multivariate analysis (37.9 vs. 4.5%; odds ratio: 67, 95% confidence interval: 6.606–2041, p = 0.003). Infants developing F-NEC achieved full feeds earlier (22.5 vs. 19.8 days, p = 0.025) on univariate but not multivariate analysis. There was no difference in the rates of NEC and F-NEC among infants receiving breast milk (standard or fortified) or formula (standard or increased caloric density; p = 0.235). Conclusion Among premature neonates with NEC, reaching full volume feedings was associated with a nearly 70-fold increased risk of F-NEC. Assuming it was possible to predict an infant's development of NEC, alternative feeding regimens might reduce the risk of F-NEC in this population.

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Cross-risks of development of bronchopulmonary dysplasia and necrotizing enterocolitis of premature neonates

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-09 ◽

2020 ◽

Vol 24 (4) ◽

pp. 611-617

Author(s):

A. V. Bolonska ◽

O. Yu. Sorokina

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Necrotizing Enterocolitis ◽

Bronchopulmonary Dysplasia ◽

Distress Syndrome ◽

Fluid Intake ◽

Neurological Status ◽

Premature Baby ◽

Respiratory Support ◽

Premature Neonates

Annotation. Bronchopulmonary dysplasia and necrotizing enterocolitis have become modern problems of effective care of premature neonates. These two pathologies significantly delay the discharge of a premature baby from the hospital, lead to significant economic costs and worsen the quality of life of these patients. The aim of the study was to identify controlled predictors of bronchopulmonary dysplasia, however, in the analysis of the initial status of patients obtained useful results for the parallel treatment of necrotizing enterocolitis. The study recruited 133 neonates with a gestational age of 28–32 weeks with a diagnosis of respiratory distress syndrome on the basis of two NICU in Dnipro in the period from 2016 to 2020. According to the results of the study in the structure of treatment of premature neonates there were significant risks of bronchopulmonary dysplasia: the duration of respiratory support by mechanical ventilation, non-invasive ventilation, additional oxygenation, nebulizer therapy, and for necrotizing enterocolitis – lower fluid intake, hemoglobin level in 1, 3, 7 days of life, moderate and severe asphyxia. Some of the approaches in therapy are cross-cutting, such as the prevention of anemia in respiratory distress syndrome, fluid intake differences and intensive care methods reducing the duration of respiratory support for the prevention of late neonatal sepsis, we can create an algorithm that takes into account all the risks and enhance outcome for these patients. The perspectives for future work – research of neurological status of former premature neonates and finding out predictors of cerebral palsy.

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