The role of host factors in an outbreak of necrotizing enterocolitis
R. P. Gaynes, S. Palmer, W. J. Martone, C. L. Holt, D. S. Buchter, L. W. Frawley, C. Perlino and W. P. Kanto Jr
During an outbreak investigation of necrotizing enterocolitis (NEC) in a
neonatal intensive care unit, we identified nine definite and six suspected
cases of NEC on the basis of histopathologic, clinical, and
roentgenographic findings. Neonates of low birth weight (less than 1,250 g)
had the highest incidence of NEC, supporting a role for prematurity in this
disease. Patients with definite NEC and those with severe clinical features
had significantly lower birth weights and postconception ages (gestational
age at birth plus postnatal age at onset of NEC) than the patients with
suspected NEC. In a case-control study using birth weight-matched control
subjects, maternal toxemia was identified as a possible protective factor
for NEC. To our knowledge, this is the first report of the relationship
between NEC disease severity and postconception age. These findings also
suggest that toxemia may be an important protective factor in NEC and
should be examined in subsequent studies.
