A Study Of Influencing Factors In Very Low Birth Weight Infants With Necrotizing Enterocolitis

Background Neonatal necrotizing enterocolitis(NEC)is the most common disease in the neonatal period,especially in very low birth weight infants,Because of it's quick onset and high mortality,it can cause serious complications.Nowadays there is no specific treatment.Because there are still numerous disputes on the relevant factors of necrotizing enterocolitis,it's necessary to analyze the relevant factors of NEC in newborns for its prevention and management in the clinical There are a lot of research reports show that breastfeeding can be significantly reduced the incidence of NEC.In 2016,milk bank was founded in the shanghai children's hospital,strengthening breastfeeding for very low birth weight infants in NICU.Therefore,we should study that breastfeeding is the protective factor for development of NEC,for promoting breastfeeding and reducing the incidence of NEC,Objective To analyze the risk or protective factors for development of NEC in very low birth weight infants and to testify that breastfeeding is the protective factor for development of NEC,for promoting breastfeeding.Methods There is a retrospective analysis on very low birth weight infants in hospital for two years,according to the way of Cohort study.The very low birth weight infants(named control group)were from neonatal intensive care units(NICU)in Children' s Hospital Jiao tong University during January,2015 and December 2015.The very low birth weight infants(named observative group)were from NICU in Children's Hospital Jiao tong University during January,2016 and December 2016.The clinical data were collected using case report forms and were analyzed and summarized,and the relevant factors for development of NEC were analyzed by logistic regression test.Results(1)Clinical featrures between observative group and control group:The incidence of NEC in observative group is significantly lower than that of control group(p<0.05).Birth gestational age,birth weight,birth length and head circumference are similar between the observative group and the control group(p>0.05).The rate of breastfeeding in observative group is significantly higher than that of control group(p<0.05),ICP(0%)and Other pregnancy complications(1.4%)in observative group are significantly lower than those of control group(p<0.05).With sepsis(13.0%),pneumonia(33.6%),combined with pneumonia and shock(2.1%)in observative group are significantly lower than those of control group(p<0.05).hs PDA(15.8%)and Umbilical Venous Catheters(UVC,19.2%)in observative group are significantly higher than those of control group(p<0.05).There are less very low birth weight infants receiving Pulmonary surfactant(61.6%)in observative group than in control group(p<0.05).The mortality(4.8%)in observative group is significantly lower than control group(p<0.05).The median of weight growth at discharge in observative group was 850g,which is more than that in control group(p<0.05).(2)Influencing factors analysis for development of NEC:There is a logistic regression analysis between breastfeeding,pregnancy complications(ICP,other),sepsis,pneumonia,combined with pneumonia and shock,hs PDA,UVC,weight growth at discharge and NEC.The logistic regression analysis reveals breastfeeding(p=0.03,OR<1)is the protective factor for development of NEC in very low birth weight infants whereas sepsis(p=0.013,OR>1)is the risk factor for development of NEC in very low birth weight infants.Conclusions breastfeeding is the protective factor for development of NEC in very low birth weight infants,whereas sepsis is the risk factor for development of NEC in very low birth weight infants.It is necessary to promote breastfeeding and facilitate the establishment of breast milk bank in very low birth weight infants for reducing the incidence of NEC.Meanwhile we should be observed carefully to avoid the development of NEC for the very low birth weight infants with sepsis and be positive in anti-infection treatment.