Infant and maternal risk factors related to necrotising enterocolitis-associated infant death in the United States

Abstract

Aim: To evaluate necrotising enterocolitis (NEC)-associated infant death and identify risk factors related to NEC infant death in the United States.

Methods: The United States Period Linked Birth/Infant Death data for 2010-2013 were utilised to determine risk factors associated with NEC infant death. Infant mortality rates (IMRs) were calculated and a retrospective matched case-control analysis was performed. An infant case was defined as having the International Classification of Diseases, Tenth Revision code for NEC listed on the death record. Controls were matched on birthweight and randomly selected. Conditional multivariable logistic regression models stratified by birthweight were conducted to determine risk factors for NEC infant death.

Results: The average annual NEC IMR was 12.5 deaths per 100 000 live births and was higher among very low birthweight (VLBW) compared to normal birthweight infants and among black compared to white infants. For VLBW infants, the multivariable analysis identified male sex, five-minute Apgar score of less than 7, and white infants born to a mother who is less than or equal to 19 years of age to be related with NEC-associated infant death.

Conclusion: Paediatricians should be aware of the factors related to NEC-associated infant death to reduce the number of infants at greatest risk for NEC and focus on racial disparities.

Keywords: Infants; Mortality; Necrotising enterocolitis; Risk factors; United States.