J Korean Med Sci.  2015 Oct;30(Suppl 1):S75-S80. 10.3346/jkms.2015.30.S1.S75.

Necrotizing Enterocolitis among Very-Low-Birth-Weight Infants in Korea

• Youn YA
• Kim EK
• Kim SY

• KMID: 2351139
• DOI: http://doi.org/10.3346/jkms.2015.30.S1.S75

Abstract

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency and remains a major cause of mortality for very-low-birth-weight infants (VLBWI) requiring surgery. To date, there have been no large-scale studies evaluating the incidence, associated clinical factors and outcomes of NEC for VLBWI in Korea. The 2,326 VLBWI of a total 2,386 Korean Neonatal Network (KNN) cohort born with a birth weight below 1,500 g between January 2013 to June 2014 were included in this analysis. The overall incidence of NEC (stage > or = 2) among VLBWI in Korea was 6.8%; 149 infants had NEC stage > or = 2 and 2,177 infants did not have NEC. Surgery was performed for 77 (53%) of the infants in the NEC group. NEC was related to lower gestational age (GA) and birth weight (P < 0.001). Multivariate logistic regression analysis demonstrated that NEC was consistently related to hypotension within one week after birth (OR 2.0, 95% CI 1.0-3.9). With respect to outcome, the NEC group had longer times to reach 100 mL/kg/day feeding (P < 0.001), longer TPN duration (P < 0.001) and hospitalization (P = 0.031) and higher PVL (P < 0.001) and mortality rate (P < 0.001). When the medical and surgical NEC groups were compared, GA was significantly lower and PDA was more found in the surgical NEC group. The overall incidence of NEC in Korea is similar to that of other multicenter studies. In addition to GA and birth weight, hypotension within a week of life is significantly related to NEC.

Keyword

Enterocolitis, Necrotizing; Incidence; Outcome; Very-low-birth-weight Infants

MeSH Terms

Birth Weight
Databases, Factual
Enterocolitis, Necrotizing/*epidemiology/mortality
Female
Gestational Age
Humans
Incidence
Infant
Infant Mortality
Infant, Newborn
Infant, Premature
*Infant, Very Low Birth Weight
Logistic Models
Male
Odds Ratio
Republic of Korea/epidemiology
Risk Factors

Figure

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  Fig. 1 NEC incidence according to gestational age (week).

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  Fig. 2 NEC incidence according to birth weight (g).

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