Neonatal necrotizing enterocolitis: a nine-year experience
R. M. Kliegman and A. A. Fanaroff
To gain an epidemiologic perspective on necrotizing enterocolitis (NEC),
nine years' experience with 123 patients was reviewed. Mean gestational age
was 31 weeks, and mean birth weight, 1,460 g; 7.3% were full-term and 10.5%
were small for gestational age. Eighty infants had umbilical artery
catheters, of which 50% were placed below L4-5. There was no identifiable
risk factor in 11.4%; in half of these infants, NEC developed during an
epidemic. Clustering of cases occurred in seven of the 108 months studied.
Cases during epidemics had a lower incidence of respiratory distress
syndrome. Average age at onset of NEC was 12 days; however the most common
agd (mode) was 3 days, and in 13.8% onset was after the third week. On the
survivors, 4% had recurrent disease one to 20 days after reinitiation of
enteric feeding. The occurrence of NEC in low-risk patients and in older
neonates raises serious questions about the proposed pathogenesis of NEC.
