Necrotizing ulcerative enterocolitis - risk factors, therapeutic interventions

Universitatea de Medicină şi Farmacie “Gr.T.Popa”, Iaşi, Spitalul Clinic de Obstetrică-Ginecologie Cuza-Vodă, Spitalul Clinic de Urgenţă pentru Copii Sf. Maria, IaşiNecrotizing enterocolitis (NEC) is the most frequent digestive emergency in the neonatal period, mainly diagnosed in the premature newborn. In this study, the authors tried to synthesize the correlation among risk factors, stage of disease and outcome. Material and methods: we carried out a retrospective study on 205 neonates with NEC, diagnosed in our NICU over 6 years. We assessed the following parameters: gestational age, birth weight, associated diseases, infection, moment of onset, type of feeding at onset, clinical staging, duration of symptoms, surgical treatment and outcome. Results: the incidence of NEC in the NICU was 3.32%. The mean GA was 33 weeks and the mean BW was 1900 grams. Associated diseases were: PDA – 19.5%, perinatal asphyxia – 13.7%, medium and severe respiratory distress – 67.8%. 39% of the neonates had positive gastric aspirates and infection was correlated with clinical staging. The onset of symptoms was 9 days of age and the mean duration of symptoms was 5 days. Both were correlated with clinical staging. Feeding at onset was predominantly parenteral, with or without enteral supplementation with formula. 16.6% of patients were transferred to Pediatric Surgery, 9.3% were performed surgery and 6.8% were deceased following surgery. Conclusions: Our results show powerful arguments both for the caution regarding nutrition of the premature newborn and for the timely therapeutic intervention in newborns with NEC