Seeman Sara M, Mehal Jason M, Haberling Dana L, Holman Robert C, Stoll Barbara J
Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.
Acta Paediatr. 2016 Jun;105(6):e240-6. doi: 10.1111/apa.13390. Epub 2016 Apr 14.
To evaluate necrotising enterocolitis (NEC)-associated infant death and identify risk factors related to NEC infant death in the United States.
The United States Period Linked Birth/Infant Death data for 2010-2013 were utilised to determine risk factors associated with NEC infant death. Infant mortality rates (IMRs) were calculated and a retrospective matched case-control analysis was performed. An infant case was defined as having the International Classification of Diseases, Tenth Revision code for NEC listed on the death record. Controls were matched on birthweight and randomly selected. Conditional multivariable logistic regression models stratified by birthweight were conducted to determine risk factors for NEC infant death.
The average annual NEC IMR was 12.5 deaths per 100 000 live births and was higher among very low birthweight (VLBW) compared to normal birthweight infants and among black compared to white infants. For VLBW infants, the multivariable analysis identified male sex, five-minute Apgar score of less than 7, and white infants born to a mother who is less than or equal to 19 years of age to be related with NEC-associated infant death.
Paediatricians should be aware of the factors related to NEC-associated infant death to reduce the number of infants at greatest risk for NEC and focus on racial disparities.
评估坏死性小肠结肠炎（NEC）相关的婴儿死亡情况，并确定美国与NEC婴儿死亡相关的风险因素。
利用2010 - 2013年美国出生/婴儿死亡关联数据来确定与NEC婴儿死亡相关的风险因素。计算婴儿死亡率（IMR）并进行回顾性匹配病例对照分析。婴儿病例定义为死亡记录上列有国际疾病分类第十版NEC编码的婴儿。对照根据出生体重进行匹配并随机选择。进行按出生体重分层的条件多变量逻辑回归模型分析以确定NEC婴儿死亡的风险因素。
NEC的平均年IMR为每10万活产中有12.5例死亡，极低出生体重（VLBW）婴儿中的该死亡率高于正常出生体重婴儿，黑人婴儿中的该死亡率高于白人婴儿。对于VLBW婴儿，多变量分析确定男性、5分钟阿氏评分低于7分以及母亲年龄小于或等于19岁的白人婴儿与NEC相关的婴儿死亡有关。
儿科医生应了解与NEC相关的婴儿死亡因素，以减少NEC风险最高的婴儿数量，并关注种族差异。
