Clinical Analyses Of Risk Factors On Neonatal Necrotizing Enterocolitis

Objective:Through retrospective analysis of clinical cases, to explore the risk factors of inducement neonatal necrotizing enterocolitis(NEC), and to provide the basis for early clinical intervention.Methods:The clinical data, including the general situation of newborn babies, perinatal information, NEC diseases before onset, before the onset of the project related treatment of35observation were retrospectively analyzed in newborns suffering from NEC (case group),who were medically treated in the1st affiliated hospital of Kunming Medical University from January1st2008to December31st2012. Set up the children without NEC during the same period in our new pediatric hospital as control group. Using SPSS17.0software to carry on the single factor analysis and multifactor analysis.Results:1.There were64cases with diagnosis of NEC during the five years, including NEC Ⅰ period of22cases (34.4%), NEC Ⅱ period of27cases(42.2%),and NEC Ⅲ period15cases (23.4%). Our NEC incidence was3.6‰(64/17562) incidence of the NEC in the neonatal ward was8.3‰(64/7682), and it was2.4%(34/1416) in the NICU; The case fatality rate of NEC was29.7%(19/64), including Ⅱ period was31.6%(6/19),and Ⅲ period was62.4%(13/19).2. In the64cases of neonatal necrotizing enterocolitis (NEC) children, included40males (62.5%) and24females (37.5%). The average gestation age was33.33±2.48weeks, which consisted of Full-term children were4(6.2%) and Premature children60(93.8%).The average birth weight were1774.84±538.10gram,including28cases of small for gestational age(43.8%) and36cases of appropriate for gestational age (56.2%).3. Single factor analysis revealed that the proportion of infants who developed preterm, SGA, gesta-tional hypertension disease, premature rupture of membranes, prenatal use of antibiot-ics, intrapartum asphyxia, apnea, sepsis, RDS, blood transfusion and mechanical ven-tilation were higher in the NEC group when comparing to the control group. The prenatal used glucocorticoid, breast-feeding, the proportion of oral probiotics is lower than the control group, the differences were statistically significant (P<0.05). The rest of the two groups has no statistically significant difference (P>0.05). Logistic regression analysis revealed that preterm birth, gestationalhypertension disease, sepsis and apnea were risk factors of NEC, whereas breastfeeding and oral probiotics were protective factors of NEC.Conclusion:This research shows that Our NEC incidence was3.6%o, incidence of the NEC in the neonatal ward was8.3%o (64/7682), and it was2.4%(34/1416) in the NICU; The case fatality rate of NEC was29.7%, among them Ⅱ period was31.6%and Ⅲ period was62.4%;This research also showed that preterm birth, gestational hypertension disease, sepsis and apnea are major risk factors for NEC, breastfeeding and oral probiotics are NEC protection factors; As far as possible reduce preterm birth, effectively control infection, advocate breastfeeding, avoiding the pathogenesis of NEC various risk factors, in order to reduce its incidence.