Late onset of necrotizing enterocolitis in the full-term infant is associated with increased mortality: Results from a two-center analysis

Scott S. Short, Stephanie Papillon, Dror Berel, Henri R. Ford, Philip K. Frykman, Akemi Kawaguchi

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose The effect of timing of onset of necrotizing enterocolitis (NEC) on outcomes has not been determined for the full-term infant. In this study we aimed to characterize the full-term NEC population and to evaluate onset of NEC. Methods We performed a two-center retrospective review of all full-term infants (≥ 37 weeks) with a diagnosis of NEC between 1990 and 2012. Patients were identified by ICD-9 and age. Early onset for NEC was ≤ 7 days and late onset after 7 days of life. Demographics, comorbidities, maternal factors, clinical factors, surgical intervention, complications, and mortality were evaluated. Wilcoxon's test was performed on continuous variables and Fisher's exact test on categorical data. A p-value < 0.05 was considered significant. Univariate outcomes with a p-value < 0.1 were selected for multivariable analysis. Results Thirty-nine patients (24 boys, 15 girls) with median EGA of 39 weeks were identified. Overall mortality was 18%. Univariate predictors of mortality included congenital heart disease and placement of an umbilical artery (UA) catheter. Multivariate analysis revealed late onset of NEC to be an independent predictor of mortality (OR 90.8, 95% CI 2.6-3121). Conclusion Full-term infants who develop NEC after 7 days of life, have congenital heart disease, and/or need UA catheterization have increased mortality.

Original languageEnglish (US)
Pages (from-to)950-953
Number of pages4
JournalJournal of Pediatric Surgery
Volume49
Issue number6
DOIs
StatePublished - Jun 2014
Externally publishedYes

Keywords

  • Full-term
  • Mortality
  • Necrotizing enterocolitis
  • Neonate
  • Term

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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