Korean J Pediatr.  2014 Dec;57(12):505-513. 10.3345/kjp.2014.57.12.505.

Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies

• Choi YY

• KMID: 2284639
• DOI: http://doi.org/10.3345/kjp.2014.57.12.505

Abstract

While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity. NEC is more prevalent in lower gestational age and lower birth weight groups. It is characterized by various degrees of mucosal or transmural necrosis of the intestine. Its exact pathogenesis remains unclear, but prematurity, enteral feeding, bacterial products, and intestinal ischemia have all been shown to cause activation of the inflammatory cascade, which is known as the final common pathway of intestinal injury. Awareness of the risk factors for NEC; practices to reduce the risk, including early trophic feeding with breast milk and following the established feeding guidelines; and administration of probiotics have been shown to reduce the incidence of NEC. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. Therefore, new potential techniques to detect early biomarkers or factors specific to intestinal inflammation, as well as further strategies to prevent the activation of the inflammatory cascade, which is important for disease progression, should be investigated.

Keyword

Necrotizing enterocolitis; Extremely premature infants; Pathophysiology; Risk factor; Prevention

MeSH Terms

Biomarkers
Birth Weight
Disease Progression
Enteral Nutrition
Enterocolitis, Necrotizing*
Gestational Age
Humans
Incidence
Infant
Infant Mortality
Infant, Extremely Premature
Infant, Newborn*
Inflammation
Intestines
Ischemia
Milk, Human
Necrosis
Probiotics
Risk Factors