Korean J Pediatr.  2011 Sep;54(9):368-372. 10.3345/kjp.2011.54.9.368.

An update on necrotizing enterocolitis: pathogenesis and preventive strategies

• Lee JH

• KMID: 1447898
• DOI: http://doi.org/10.3345/kjp.2011.54.9.368

Abstract

Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birth-weight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

Keyword

Necrotizing enterocolitis; Infant; Premature; Pathogenesis; Prevention

MeSH Terms

Anemia
Arginine
Bacteria
Birth Weight
Breast Feeding
Bronchopulmonary Dysplasia
Colon
Cross Infection
Enterocolitis, Necrotizing
Erythrocyte Transfusion
Gastrointestinal Tract
Glutamine
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Ischemia
Lactoferrin
Malnutrition
Milk Proteins
Polymorphism, Genetic
Prebiotics
Probiotics
Retinopathy of Prematurity
Arginine
Glutamine
Lactoferrin
Milk Proteins
Prebiotics