Maternal Risk Factors for Focal Intestinal Perforation and Necrotizing Enterocolitis

For parents diagnosis of necrotizing enterocolitis (NEC) or focal intestinal perforation (FIP) is extremely difficult to stand, because survival rate is highly dependent on presence of intestine perforation. Determination was to describe possible maternal risk factors for NEC and FIP.

Case control design was used to compare NEC without (n=27) or with perforation (NECp; n=37) to FIP (n=12) and the control group (CG; n=30). Analysis of mothers’ records and prenatal questionnaires are followed by a structured interview. Effort was on medical history, drug consumption, complications during pregnancy, life habits and external risk factors. The local ethic committee approved this study.

NEC and NECp mothers took more contraceptives (p=0.001), paracetamol (p=0.004), iodide (p=0.05) and calcium (p=0.04). NECp and FIP mothers suffered of hypertension (p=0.048) and took more antibiotics (p<0.001), while FIP mothers consumed more alcohol than NEC, NECp or CG (p=0.034). NEC mothers showed significantly more often uterine isthmus insufficiency (p=0.042). NEC and NECp mothers suffered more of premature placental detachment than FIP mothers (p=0.047), which grieved of prolapsing amniotic sac (p=0.028) and used more iodide (n=0.05). NEC and NECp fathers smoked significantly more cigarettes/d than FIP fathers (p=0.049). Body weight and external risk factors showed no influence.

The accumulation of several risk factors could lead to NEC or NECp, while other factors in combination could result in FIP. In clinical practice, we should be aware of these risk factors in order to detect potentially preterm prior perforation, which influences negatively survival rate, occurs.