Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct 20;3(4):45.
eCollection 2014 Oct-Dec.

NEC in Twin Pregnancies: Incidence and Outcomes

Sathyaprasad C Burjonrappa  1 , Brian Shea  1 , Diya Goorah  1
Affiliations

NEC in Twin Pregnancies: Incidence and Outcomes

Sathyaprasad C Burjonrappa et al. J Neonatal Surg. .

Abstract

Background: Necrotizing Enterocolitis (NEC) is the most common gastrointestinal emergency in neonates. Previously established risk factors for the development of NEC include prematurity and low birth weight. However, it is not clear to date as to whether the etiology of NEC is due to host, environmental, or yet other unknown factors. We analyzed the differences in incidence of NEC in twin pregnancies to further clarify its etio-pathogenesis.

Methods: After IRB approval, a retrospective search of the medical records of the Department of Pediatric Surgery was done to identify all the neonates treated for surgical NEC from 2006-2013. Patients that had been treated for NEC elsewhere and subsequently transferred in to our facility were excluded. The medical records of the resulting 45 patients were then analyzed for demographics, antenatal screening, risk factors, treatment (medical and surgical), and outcomes. The resulting data was then analyzed using relative risk calculations and standard statistical tests.

Results: Of the 45 patients who developed surgical NEC, 9 neonates (20%) were born of a twin pregnancy. There were no cases in which both twin A and twin B developed NEC. NEC in twin pregnancy neonates showed a female preponderance (p less than 0.0001) and developed universally in the first born of the twins. Birth weight, time of onset of NEC, hospital stay and mortality were similar between twin and non-twin NEC. There was an average lead-time of three weeks to development of NEC in both singletons and twin pregnancies.

Conclusion: There is a remarkable higher incidence of NEC amongst twins. Abnormal colonization of the gastrointestinal tract appears to be an immediate postpartum event. NEC in twin pregnancy does not appear to have a deleterious outcome compared to NEC in singleton pregnancy.

Keywords: NEC; Pregnancy; Twin.

PubMed Disclaimer

Figures

None
Table I: Demographic characteristics and clinical features of NEC patients
See this image and copyright information in PMC

References

    1. Guthrie SO, Gordon PV, Thomas V, Peabody J, Clark RH. Necrotizing enterocolitis among neonates in the United States. J Pernatol. 2003; 23: 278-85. - PubMed
    1. Hawkes CH. Twin studies in medicine-what do they tell us? QJM. 1997; 90:311-21. - PubMed
    1. Samm M, Curtis-Cohen M, Keller M, Chawla H. Necrotizing enterocolitis in infants of multiple gestation. Am J Dis Child. 1986; 140:937-9. - PubMed
    1. Powell RW1, Dyess DL, Luterman A, Simon NP, Ramenofsky ML. Necrotizing enterocolitis in multiple-birth infants. J Pediatr Surg. 1990; 25:319-21. - PubMed
    1. Mackie RI, Sghir A, Gaskins HR. Developmental microbial ecology of the neonatal gastrointestinal tract. Am J Clin Nutr. 1999; 69:1035-45. - PubMed

LinkOut - more resources