What is the prevalence of enterocolitis (NEC) in premature infants?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Answer

As many as 50% of all premature infants manifest feeding intolerance during their hospital course, but less than one fourth of those infants develop necrotizing enterocolitis (NEC). As with all neonatal care, the risks and benefits of various clinical approaches to NEC must be considered carefully.

In a study of extremely low birth weight infants, standardized slow enteral feeding (SSEF) was associated with a reduced risk of NEC compared with early enteral feeding. A total of 125 infants were treated with the SSEF protocol; these infants were compared with 294 historic controls. Days to full feeds ranged from 16 to 22 among controls, from 44 to 52 days for babies weighing under 750 grams in the SSEF group, and from 32 to 36 days for infants in the SSEF group weighing 750 to 1,000 grams at birth. [36, 37]

NEC occurred in 5.6% of infants in the SSEF group and 11.2% of infants in the control group, and 1.6% of SSEF infants and 4.8% of controls required surgery for NEC. Among infants weighing less than 750 grams at birth, the risk of NEC was 2.1% in the smallest SSEF babies, compared to 16.2% for the smallest infants in the control group. Risk of combined NEC and death was 12.8% for infants in the SSEF group weighing less than 750 grams, and 29.5% for small infants in the control group. Infants on the SSEF protocol who developed NEC got sick at 60 days of age, on average, compared to 30 days for controls. Among surviving infants, there was no difference between SSEF and control infants in discharge weight or length. [36, 37]


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