Understanding of Clinical Presentation, Timing of Presentation and the Outcome in the Development of Necrotizing Enterocolitis

Title: Understanding of Clinical Presentation, Timing of Presentation and the Outcome in the Development of Necrotizing Enterocolitis

Authors: Petrice Vienetha, Dr Sun Bin

DOI: https://dx.doi.org/10.18535/jmscr/v4i12.38

Abstract

Background: Necrotizing Enterocolitis (NEC) remains as the disease with significant morbidity and mortality in preterm infants. The lack of universally reliable diagnostic criteria makes it difficult to establish the diagnosis. By understanding the clinical presentation and timing of presentation in the development of NEC, it will help in the management of the disease, thus contributing in the outcome of the disease. Incomplete knowledge regarding NEC impedes the diagnosis and treatment of patients with the disease.

Objective: This study was initiated to give a better understanding regarding the clinical features and onset of NEC in neonatal, to evaluate the correlation of clinical presentation, timing of development and the outcome of the disease among Chinese infants in Suzhou.

Methods: This non-interventional, retrospective study was conducted at Children Hospital of Soochow University including infants admitted to the Neonatal Department during 5 years period, from June 2010 to June 2015, diagnosed with Necrotizing Enterocolitis. Data used in this study were collected from the hospital database. Cases with confirmed diagnosis of Necrotizing Enterocolitis (based on Bell staging) were evaluated. Cross tabulation, chi square and regression analysis test were used to find the correlation and P < 0.05 was considered to be the statistically significant value.

Results: A total of 100 infants (N=100) included in this study, 61% were male and 39 % were female. As expected preterm is highly associated with the development of NEC, but the more premature the infant the later will be the time presentation. Early-onset NEC infants had lower incidence of respiratory distress syndrome. Early identification and better understanding of clinical features of NEC in neonatal may reduce the incidence and improve the outcome in NEC. Further studies are required to understand the etiology of this disease process.

Conclusion: 1) Despite improvements in neonatal intensive care, NEC remains a critical disease in preterm infants and confers many serious complications and mortality. 2) Preterm newborns are highly associated with the development of NEC. 3) The more premature the infant, the later will be the onset of the disease. 4)Early-onset NEC infants had lower incidence of respiratory distress syndrome. 5) Proposition that in pretem infants clinical presentation of NEC differs from that in term infants has been made, in which term infants is associated more with underlying congenital conditions (e.g congenital heart disease) 6)Clear diagnostic criteria need to be used consistently to differentiate between NEC and other entities.

Keywords: Necrotizing Enterocolitis / Clinical Presentation / Neonatal / Timing / Outcome.

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Corresponding Author

Petrice Vienetha

Department Chief of Neonatology,

Children Hospital Affiliated to Soochow University