Clinical Analysis Of Risk Factors And Prognostic Factors Of Small For Gestational Age Infants With Necrotizing Nterocolitis

Objective To investigate the risk factors of neonatal necrotizing enterocolitis(NEC)in small for gestational age infants(SGA)and the prognostic factors of NEC in SGA;To compare the clinical characteristics of SGA with that of the appropriate for gestational age(AGA)with NEC,so as to provide clinical reference evidence for early prevention,diagnosis,treatment and improvement of prognosis and improve the level of neonatal treatment.Methods The clinical data of 45 children with SGA and NEC,50 children without NEC and 50 children with AGA and NEC from January 1,2017 to December 30,2022 were analyzed retrospectively.In SGA,45 children with NEC were in the SGA / NEC group,and 50 children without NEC were in the SGA /non-NEC group.According to the prognosis,the children in SGA / NEC group were divided into 30 cases of cure group and 15 cases of poor prognosis group.According to gestational age and birth weight,NEC children in our hospital were divided into SGA / NEC group and AGA / NEC group.SPSS 26.0 statistical software was used to process and analyze the data of general clinical data,birth history,related information of pregnant mother,feeding plan before onset,treatment measures after admission,post-admission complications,post-onset laboratory examination and prognosis of children in each group.Results Of the 723 small for gestational age infants,45 were diagnosed as NEC,with an incidence of 0.06%.Compared with the clinical data of SGA/NEC group and SGA / non-NEC group,univariate analysis showed that there were statistically significant differences between the two groups in terms of pregnancy with hypertension during pregnancy,gestational age,birth weight,time and quantity of first milk,feeding route and feeding mode before the onset of disease,sepsis and umbilical vein catheterization(P < 0.05).Logistic regression analysis showed that maternal hypertension complicating pregnancy,neonatal septicemia and umbilical vein catheterization were independent risk factors affecting the occurrence of NEC in SGA.Compared with the clinical data of children with NEC in the cure group and the poor prognosis group,univariate analysis showed that there were significant differences between the two groups in Bell stage and CRP after onset(P < 0.05).Logistic regression analysis showed that stage Ⅲ NEC and increased CRP after onset were independent risk factors for poor prognosis of SGA with NEC.The comparison of clinical data between SGA / NEC group and SGA / NEC group showed that there were significant differences in gestational age,birth weight,feeding mode,total days of hospitalization,Bell stage,bloody stool,bowel sound weakening,prognosis.Conclusion Pregnant women with hypertension,neonatal sepsis,and umbilical vein catheterization are independent risk factors for NEC in SGA;Phase III NEC and elevated CRP levels after diagnosis of NEC are independent risk factors for poor prognosis of SGA complicated with NEC;Compared with AGA,factors such as small gestational age and low birth weight are more likely to lead to NEC in SGA.Compared with AGA,the severity of SGA after NEC onset is more severe and the prognosis is worse.