Zozaya Carlos, García González Inés, Avila-Alvarez Alejandro, Oikonomopoulou Niki, Sánchez Tamayo Tomás, Salguero Enrique, Saenz de Pipaón Miguel, García-Muñoz Rodrigo Fermín, Couce María L
Division of Neonatology, Hospital for Sick Children, Toronto, ON, Canada.
Neonatology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela, A Coruña, Spain.
Front Pediatr. 2020 May 13;8:188. doi: 10.3389/fped.2020.00188. eCollection 2020.
Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incidence, treatment, and mortality over the last decade in Spain. Multicenter cohort study with data from the Spanish Neonatal Network-SEN1500 database. The study period comprised from January 2005 to December 2017. Preterm infants <32 weeks of gestational age at birth without major congenital malformations were included for analysis. The main study outcomes were necrotizing enterocolitis incidence, co-morbidity (bronchopulmonary dysplasia, late-onset sepsis, cystic periventricular leukomalacia, retinopathy of prematurity, acute kidney injury), mortality, and surgical/non-surgical treatment. Among the 25,821 included infants, NEC incidence was 8.8% during the whole study period and remained stable when comparing 4-year subperiods. However, more cases were surgically treated (from 48.8% in 2005-2008 to 70.2% in 2015-2017, < 0.001). Mortality improved from 36.7% in the 2005-2008 to 26.6% in 2015-2017 ( < 0.001). Breastfeeding rates improved over the studied years (24.3% to 40.5%, < 0.001), while gestational age remained invariable (28.5 weeks, = 0.20). Prophylactic probiotics were implemented during the study period in some units, reaching 18.6% of the patients in 2015-2017. The incidence of necrotizing enterocolitis remained stable despite the improvement regarding protective factors frequency. Surgical treatment became more frequent over the study period, whereas mortality decreased.
关于坏死性小肠结肠炎发病率和死亡率趋势的数据在文献中很少见。最近，一些预防策略已得到证实（益生菌）或有所增加（母乳喂养率）。本研究旨在描述西班牙过去十年中坏死性小肠结肠炎的发病率、治疗情况和死亡率趋势。对来自西班牙新生儿网络-SEN1500数据库的数据进行多中心队列研究。研究期间为2005年1月至2017年12月。纳入出生时胎龄<32周且无重大先天性畸形的早产儿进行分析。主要研究结果包括坏死性小肠结肠炎发病率、合并症（支气管肺发育不良、晚发性败血症、脑室周围白质软化症、早产儿视网膜病变、急性肾损伤）、死亡率以及手术/非手术治疗。在纳入的25821名婴儿中，整个研究期间坏死性小肠结肠炎的发病率为8.8%，在比较4年子期间时保持稳定。然而，接受手术治疗的病例增多（从2005 - 2008年的48.8%增至2015 - 2017年的70.2%，<0.001）。死亡率从2005 - 2008年的36.7%降至2015 - 2017年的26.6%（<0.001）。在研究期间，母乳喂养率有所提高（从24.3%提高到40.5%，<0.001），而胎龄保持不变（28.5周，P = 0.20）。在研究期间，一些单位实施了预防性益生菌，2015 - 2017年达到患者的18.6%。尽管保护因素的频率有所改善，但坏死性小肠结肠炎的发病率仍保持稳定。在研究期间，手术治疗变得更加频繁，而死亡率下降。
