Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study

Background: Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups. Methods: Risk factors associated with NEC were investigated using a retrospective case-control design. Patients with Bell's Stage NEC >= II were divided into three groups based on GA: I, <34 weeks; II, >= 34 weeks but <37 weeks; III, >= 37 weeks. Each case was paired with two GA- and weight-matched controls. Data were collected from medical records, and univariate and conditional logistic regression analyses employed. Results: A total of 238 cases and 476 controls were enrolled. Variation in the months when NEC was diagnosed was noted, with a peak in January and a trough in August. Intrahepatic chole-stasis of pregnancy and transfusion with packed red blood cells were significantly associated with NEC in preterm infants. Meconium aspiration syndrome was an independent risk factor for a greater chance of NEC development in full-term infants. Postnatal asphyxia and sepsis were associated with an increased risk of NEC in all groups. Probiotic use was associated with a reduced risk of NEC. Patients aged >34 weeks with congenital heart disease were more likely than controls to have NEC. Conclusion: Intrahepatic cholestasis of pregnancy and meconium aspiration syndrome may be new risk factors for NEC. Copyright (C) 2016, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC.