Risk Factors Associated with Lethal Outcome of Necrotizing Enterocolitis in Premature Born Infants

Introduction: Necrotizing enterocolitis (NEC) is a life-threatening disease characterized by necrosis of the intestinal wall, which mainly affects premature infants. The total mortality of NEC varies from 10% to 50%, reaching almost 100% with the most severe forms of the disease.

Objective: to establish risk factors associated with lethal outcome of NEC in premature born infants.

Methods: The trial involved 21 premature infants with NEC who died in the period 2015-2019. To establish risk factors of death, we compared children with NEC who died (n=21) with children who survived and had similar stages of NEC (n=43) and was calculated by determining an odds ratio (OR) and χ2Pearson using the calculator MEDCALC.

Results: Causes of death in children with NEC were endogenous intoxication in 38.1%, acute renal failure - 38.1%, diffuse peritonitis – in 14.3%, respiratory distress syndrome - in 9.5%. The risk of death in children with NEC was associated with maternal infection during pregnancy (χ2=7,182;p=0,008;OR=4,675) - increases the risk by 4 times; blood transfusion in children (χ2=8,557;p=0,004;OR=8,262) - increases the risk by 8 times; development of DIC syndrome (χ2=14,592;p<0,001; R=10,725) - increases the risk by 10 times; thrombocytopenia (χ2=4,866;p=0,028;OR=4,320) - increases the risk by 4 times; development of multiple organ disfunction (χ2=17,578;p<0,001;OR=12,364) - increases the risk by 12 times.

Conclusions: Our data show that the risk of death in children with NEC was associated with maternal infection during pregnancy, blood transfusion in children, thrombocytopenia, the development of DIC and multiple organ disfunction. Refined risk factors for death in premature infants on the background of NEC will provide an opportunity to identify children who need increased attention of doctors to the treatment and further management of these patients with the use of preventive technologies that can prevent catastrophic consequences.