Department of Neonatology, Ya'an People's Hospital, Ya'an, Sichuan, PR China.
Nursing Department, Ya'an People's Hospital, Ya'an, Sichuan, PR China.
Medicine (Baltimore). 2022 Feb 18;101(7):e28789. doi: 10.1097/MD.0000000000028789.
There are needs to investigate the influencing factors of necrotizing enterocolitis (NEC) in low birth weight (LBW) newborns, to provide insights into the clinical management of NEC.This study was a retrospective cohort study. Infants admitted to our hospital from January 1, 2019 to June 30, 2021 were selected. The clinical characteristics of NEC and no-NEC infants were evaluated. Logistic regression analyses were conducted to assess the risk factors of NEC in LBW infants.A total of 192 LBW infants were included, the incidence of NEC in LBW infants was 35.42%. There were significant differences in the congenital heart disease, sepsis, breastfeeding, blood transfusion and probiotics feeding between NEC and no-NEC group (all P < .05), and there were no significant differences in birth weight, gestational age, mother's pregnancy-induced hypertension, premature rupture of fetal membrane, amniotic fluid pollution, fetal asphyxia, neonatal respiratory distress syndrome and mechanical ventilation between NEC and no-NEC group (all P > .05). Congenital heart disease (OR: 2.128, 95% CI: 1.103-3.511), sepsis (OR: 1.630, 95% CI: 1.022-2.549), and blood transfusion (OR: 1.451, 95% CI: 1.014-2.085) were the independent risk factors for NEC in LBW infants, and breastfeeding (OR: 0.494, 95% CI: 0.023-0.928), probiotics feeding (OR: 0.816, 95% CI: 0.782-0.982) were the protective factors for the NEC in LBW infants. The prognosis of NEC infants undergone surgery treatment was better than that of infants undergone conservative treatments (P = .043).The incidence of NEC in LBW is high, which is affected by many factors, and comprehensive interventions targeted on the risk and protective factors should be made to improve the prognosis of LBW infants.
需要调查低出生体重（LBW）新生儿坏死性小肠结肠炎（NEC）的影响因素，为 NEC 的临床管理提供参考。本研究为回顾性队列研究。选取 2019 年 1 月 1 日至 2021 年 6 月 30 日我院收治的患儿，评估 NEC 与非 NEC 患儿的临床特征，采用 Logistic 回归分析评估 LBW 患儿发生 NEC 的危险因素。
共纳入 192 例 LBW 患儿，NEC 发生率为 35.42%。NEC 组与非 NEC 组在先天性心脏病、败血症、母乳喂养、输血及益生菌喂养方面比较，差异有统计学意义（均 P<0.05），两组在出生体重、胎龄、母亲妊娠期高血压、胎膜早破、羊水污染、胎儿宫内窘迫、新生儿呼吸窘迫综合征及机械通气方面比较，差异无统计学意义（均 P>0.05）。先天性心脏病（OR：2.128，95%CI：1.1033.511）、败血症（OR：1.630，95%CI：1.0222.549）、输血（OR：1.451，95%CI：1.0142.085）是 LBW 患儿发生 NEC 的独立危险因素，母乳喂养（OR：0.494，95%CI：0.0230.928）、益生菌喂养（OR：0.816，95%CI：0.782~0.982）是 LBW 患儿发生 NEC 的保护因素。手术治疗的 NEC 患儿预后优于保守治疗患儿（P=0.043）。
LBW 患儿 NEC 发生率较高，受多种因素影响，针对危险因素和保护因素采取综合干预措施，可能改善 LBW 患儿的预后。
