Clinical Analysis Of Risk Factors Of Neonatal Necrotizing Enterocolitis

Objective:A retrospective analysis was performed to analyze the clinical data of hospitalized children with neonatal necrotizing enterocolitis(NEC),to explore the risk factors and protective factors about this disease.The aim was to provide data support for early warning and intervention of NEC.Methods:Have collected neonatal medical records from the neonatology department of the Northwest Women’s and Children’s Hospital from January 1,2015 to August 31,2018.These neonates whose discharge diagnosis including necrotizing enterocolitis without gastrointestinal malformation with complete medical records and treated by surgical treatment of necrotizing enterocolitis(NEC group).Using a 1:1 paired design,each neonate in the NEC group was matched with a neonate who was hospitalized at the same time and had a difference in gestational age of less than 1 week without NEC(control group),Their medical records were collected and included in the study.The clinical data of neonates with and without NEC were analyzed by SPSS19.0 statistical software.The quantitative data were analyzed by t test.The qualitative data were analyzed byχ~2 test.Single factor and multivariate logistic regression analysis were performed.The test level isα=0.05.To analyzed the risk factors and protective factors of children with NEC(by surgical treatment)admitted to this neonatology department.Clinical data includes the following aspects:(1)Basic information:gender,gestational age,birth weight,etc.(2)Prenatal factors(individual and mother’s condition):including conception of pregnancy,mode of delivery,multiple births,placenta,amniotic fluid,mother’s main pregnancy complication,if used some special drugs before production and so on.(3)Post-hospital conditions and treatment:mainly include the use of ventilator and pulmonary surfactant,presence or absence of umbilical vein catheterization,feeding,antibiotic use,probiotics use,treatment of jaundice,complications,etc.(4)Perioperative survey:This investigation was conducted in children with NEC.Including the main clinical symptoms of the disease,imaging findings,conservative treatment,age of surgery,surgical methods,laboratory results before and after surgery,postoperative supportive treatment(intravenous nutrition therapy,antibiotic treatment and so on).(5)Treatment outcomes and health economics survey:mainly includes the outcome,hospitalization days,medical expenses and so on.Results:There were 30 cases in the NEC group and 30 cases in the control group.Univariate analysis of risk factors for NEC showed that prenatal,chorioamnionitis,maternal prebiotic use,maternal gestational anemia,pre-onset antibiotic exposure in children,and intracranial hemorrhage in children were statistically significant.(P<0.05).Multivariate logistic regression analysis showed that chorioamnionitis(OR=4.590,95%CI:1.100-19.155)and early antibiotic exposure(OR=4.508,95%CI:1.145-17.743)were risk factors for NEC.Mothers used antibiotics prenatally(OR=0.156,95%CI:0.036-0.671)as a protective factor for NEC.Conclusions:Chorioamnionitis,early exposure to antibiotics in children is a risk factor for NEC,and prenatal use of antibiotics is a protective factor.