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Michael Samm, MD; Marjorie Curtis-Cohen, MD; Marc Keller, MD; Harbhajan Chawla, MD

Am J Dis Child. 1986;140(9):937-939.

Abstract
• We examined the records of ten pairs of twins and one set of triplets among whom one or more infants had necrotizing enterocolitis (NEC). Perinatal asphyxia and respiratory distress were less common in the firstborn infants. It might, therefore, be anticipated that necrotizing enterocolitis was less common in this group. We found the reverse to be true. In all of the twin pairs twin A had NEC, and in no case did only twin B have NEC. The disease developed in triplet B but not in triplets A or C. Examination of associated risk factors revealed that the firstborn infants were more stable, were fed sooner, and had feedings advanced somewhat more rapidly than their counterparts. We reemphasize that there are unrecognized risk factors in the pathogenesis of NEC and that a high index of suspicion should be maintained for all premature infants despite their apparent stability.

(AJDC 1986;140:937-939)

Author Affiliations
From the Departments of Pediatrics (Drs Samm, Curtis-Cohen, and Chawla) and Radiology (Dr Keller), Hahnemann University School of Medicine, Philadelphia.

Footnotes
Accepted for publication May 6, 1986.

Reprint requests to Department of Pediatrics, Hahnemann University Hospital, Broad and Vine streets, Philadelphia, PA 19102-1192 (Dr Chawla).

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