Department of Paediatrics and Child Health, Aga Khan University Hospital Nairobi, Nairobi, Kenya.
Kenya Medical Research Institute Nairobi, Nairobi, Kenya.
J Matern Fetal Neonatal Med. 2023 Dec;36(2):2253351. doi: 10.1080/14767058.2023.2253351.
To evaluate the incidence and modifiable risk factors for Necrotizing enterocolitis (NEC) in preterm infants born at ≤32 weeks of gestation weighing <1500 grams, at a private tertiary care hospital in Kenya.
This retrospective cohort study was conducted at the Aga Khan University Hospital Neonatal Intensive Care Unit (NICU). Preterm infants born at ≤ 32 weeks' gestation and weighing <1500 grams admitted to NICU between 2009 and 2019, were recruited into the study. The primary outcome was NEC Bell Stage IIa-IIIb based on Modified Bell's criteria. Maternal and neonatal characteristics were evaluated. The association between variables of interest and NEC was determined using logistic regression analysis and the incidence of NEC for the study period was calculated.
A total of 261 charts of infants born at ≤ 32 weeks' gestation, weighing <1500 were reviewed, and 200 charts met the inclusion criteria. Fifteen preterm infants developed the primary outcome of interest: NEC Stage ≥2a within the first 30 days of admission. The overall incidence of NEC for the study period was 7.5%. Three risk factors were identified as significantly associated with NEC on multivariate logistic regression analysis: antenatal exposure to steroids (OR = 0.056 CI = 0.003-0.964 = 0.047), cumulative duration of exposure to invasive mechanical ventilation (OR = 2.172 CI = 1.242-3.799 = 0.007) and cumulative duration of exposure to umbilical vein catheter (OR = 1.344 CI = 1.08-1.672 = 0.008).
The overall incidence for the study period of NEC Stage ≥ II a was 7.5%. Exposure to antenatal steroids, duration of mechanical ventilation, and duration of umbilical vein catheterization were three independent modifiable risk factors for NEC Stage II a-Stage III b.
评估肯尼亚一家私立三级护理医院出生胎龄≤32 周、体重<1500 克的早产儿患坏死性小肠结肠炎（NEC）的发生率和可改变的危险因素。
本回顾性队列研究在 Aga Khan 大学医院新生儿重症监护病房（NICU）进行。2009 年至 2019 年间，在 NICU 收治胎龄≤32 周、体重<1500 克的早产儿中，纳入本研究。主要结局为根据改良的 Bell 标准，NEC Bell Ⅱa-Ⅲb 期。评估了母亲和新生儿的特征。使用逻辑回归分析确定感兴趣变量与 NEC 的相关性，并计算研究期间 NEC 的发生率。
共回顾了 261 份出生胎龄≤32 周、体重<1500 克的婴儿病历，其中 200 份符合纳入标准。15 名早产儿在入院后 30 天内出现主要结局：NEC 期≥2a。研究期间，NEC 的总发生率为 7.5%。多变量逻辑回归分析确定了三个与 NEC 显著相关的危险因素：产前接触类固醇（OR=0.056，CI=0.003-0.964，P=0.047）、有创机械通气暴露时间总和（OR=2.172，CI=1.242-3.799，P=0.007）和脐静脉导管暴露时间总和（OR=1.344，CI=1.08-1.672，P=0.008）。
研究期间 NEC Ⅱa 期的总发生率为 7.5%。产前接触类固醇、机械通气时间和脐静脉导管置管时间是 NEC Ⅱa-Ⅲb 期的三个独立可改变的危险因素。
