Clinical Characteristics and Predisposing Factors in Full-term and Preterm Neonates with Necrotizing Enterocolitis.

Shim,  So Yeon; Jung,  Kyung Eun; Kim,  Eun Sun; Lee,  Jin A; Kim,  Ee Kyung; Kim,  Han Suk; Kim,  Beyong Il; Kim,  In One; Choi,  Jung Hwan; Park,  Gui Won

Original Article

Journal of the Korean Society of Neonatology 2005;12(1):79-86.
Published online May 1, 2005.

Clinical Characteristics and Predisposing Factors in Full-term and Preterm Neonates with Necrotizing Enterocolitis.

So Yeon Shim, Kyung Eun Jung, Eun Sun Kim, Jin A Lee, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim, In One Kim, Jung Hwan Choi, Gui Won Park

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea. neona@plaza.snu.ac.kr
²Department of Radiology, College of Medicine, Seoul National University, Seoul, Korea.
³Department of General surgery, College of Medicine, Seoul National University, Seoul, Korea.

만삭아와 미숙아에서 괴사성 장염의 임상양상과 선행 인자 비교

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Abstract

PURPOSE
The purpose of this study is to compare the clinical characteristics and predisposing factors of necrotizing enterocolitis (NEC), primarily a disease of the premature, in between term and preterm groups. METHODS: We retrospectively reviewed the medical records of 36 neonates with NEC (> or =modified Bell's staging criteria IIa) who were admitted to the NICU of Seoul National University Children's Hospital from January 1, 2000 through December 31, 2004. 20 full and 16 preterm neonates were compared in regard to demographics, clinical characteristics and predisposing factors. RESULTS: 29/36 neonates(80.6%) were outborn. Mean gestational age and birth weight were 38.5+/-0.9 weeks and 3, 010+/-490 g, term and 31.4+/-3.4 weeks and 1, 460+/-750 g, in preterm respectively group. Mean age at diagnosis was 17.3+/-13.5 days in term versus 20.8+/-19.6 days in preterm group. Abdominal distension was the most common finding in both groups and diarrhea was significantly more common in term group. Congenital heart disease, intrauterine growth retardation, bacterial infection were found in 75.0% of term group. The rates of surgical intervention and complication were higher in preterms, however, mortality rate was higher in term group. Congenital heart disease, especially the presence of complex heart disease with poor systemic perfusion or heart failure, was associated with higher mortality. CONCLUSION: Diarrhea was more common in term group. Neonates with predisposing factors for NEC, especially in term neonates with congenital heart disease, should be followed closely for early diagnosis and proper treatment.

Key Words: Necrotizing enterocolitis; Predisposing factor; Preterm; Term; Neonates