Clinical Analyses Of Risk Factor On Necrotizing Enterocolitis And The Effect Of Prophylactic Use Of Probiotic On It

Objective:To explore the efficacy of Bifid Lriple Viable(BIFICO),an oral probiotic for the prevention of necrotizing enterocolitis(NEC)in low birth weight(LBW)preterm infants.The independent risk factors for NEC were also assessed.Methods:Between January 2017 and December 2017,low birth weight preterm infants admitted to neonatology department,The First Affiliated Hospital of Nanchang University,were included in this study.The patients were divided into observation group who received Bifid Lriple Viable,and control group without probiotics treatment,according to retrospectively analyized by the baseline characteristics patient data.The occurrence of NEC were observed.Univariate χ2 analysis was used to identify correlation factors,and then the risk factors for NEC and the efficacy of probiotic in the prevention of NEC were analysed by logistic regression analysis.Results:1.A total of 241 patients were included in this study,with 24 cases of NEC.The overall incidence of NEC was 9.9%.The incidence of NEC in prophylactic probiotic therapy group was 5.4%(6 of 111)compared to 13.8%(18/111)in the control group.There was a statistically significant differences in the incidence of NEC between the two groups,with regard to prophylactic probiotic patients are at a 0.356-fold reduced risk of occurrence of NEC than control patients(P=0.029,OR=0.356).2.Single factor analysis revealed that the proportion of gestational diabetes,prenatal use of glucocorticoids,one of multiplets,invasive operation,transfusion of red blood cells,NRDS,neonatal pneumonia,neonatal respiratory failure,anemia,congenital heart disease,prenatal asphyxia,hypokalemia,hyponatremia and neonatal cholestasis disease were higher in the NEC group when comparing to the control group.In contrary,the proportion of birth weight≥1500 g,gestational age≥32 weeksand oral probiotics were lower in the NEC group(P<0.05).3.Logistic regression analysis revealed that gestational age≥32 weeks(OR =0.169)and oral probiotics(OR = 0.020)were protective factors of NEC,whereas neonatal pneumonia(OR = 5.343)and gestational diabetes(OR = 28.754)were risk factors of NEC.Conclusions:1.Oral probiotics have a preventive effect on the occurrence of low birth weight premature infants NEC.2.Neonatal pneumonia and gestational diabetes are risk factors of NEC,whereas gestational age≥32 weeks and oral probiotics are protective factors of NEC in low birth weight premature infant.