Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study

Frontiers in Pediatrics

article

Carlos Zozaya¹  Inés García González²  Alejandro Avila-Alvarez³  Niki Oikonomopoulou¹  Tomás Sánchez Tamayo⁴  Enrique Salguero⁴  Miguel Saenz de Pipaón⁵  Fermín García-Muñoz Rodrigo⁷  María L. Couce² 

[1] Division of Neonatology, Hospital for Sick Children;Neonatology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela;Neonatal Unit, Department of Paediatrics, Complexo Hospitalario Universitario A Coruña, Institute for Biomedical Research A Coruña;Neonatology Department, Malaga Regional Hospital, Malaga Biomedical Research Institute-IBIMA;Neonatology Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research;Maternal and Child Health and Development Research Network, Carlos III Health Institute;Division of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil

关键词: necrotizing enterocolitis;    preterm infant;    mortality;    morbidity;    trends;   

DOI  :  10.3389/fped.2020.00188

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incidence, treatment, and mortality over the last decade in Spain. Methods: Multicenter cohort study with data from the Spanish Neonatal Network–SEN1500 database. The study period comprised from January 2005 to December 2017. Preterm infants <32 weeks of gestational age at birth without major congenital malformations were included for analysis. The main study outcomes were necrotizing enterocolitis incidence, co-morbidity (bronchopulmonary dysplasia, late-onset sepsis, cystic periventricular leukomalacia, retinopathy of prematurity, acute kidney injury), mortality, and surgical/non-surgical treatment. Results: Among the 25,821 included infants, NEC incidence was 8.8% during the whole study period and remained stable when comparing 4-year subperiods. However, more cases were surgically treated (from 48.8% in 2005–2008 to 70.2% in 2015–2017, p < 0.001). Mortality improved from 36.7% in the 2005–2008 to 26.6% in 2015–2017 ( p < 0.001). Breastfeeding rates improved over the studied years (24.3% to 40.5%, p < 0.001), while gestational age remained invariable (28.5 weeks, p = 0.20). Prophylactic probiotics were implemented during the study period in some units, reaching 18.6% of the patients in 2015–2017. Conclusions: The incidence of necrotizing enterocolitis remained stable despite the improvement regarding protective factors frequency. Surgical treatment became more frequent over the study period, whereas mortality decreased.

【 授权许可】

CC BY