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Observational Study
. 2024 Aug;113(8):1811-1817.
doi: 10.1111/apa.17253. Epub 2024 Apr 26.

Necrotising enterocolitis in a middle-income country: Early onset and risk factors for mortality

Evelyne Assenga  1   2 , Lloyd Tooke  1
Affiliations
Observational Study

Necrotising enterocolitis in a middle-income country: Early onset and risk factors for mortality

Evelyne Assenga et al. Acta Paediatr. 2024 Aug.

Abstract

Aim: There is limited literature available about necrotising enterocolitis (NEC) in low- and middle-income countries. This study sought to determine the proportion, pattern and risk factors for mortality among very low birth weight (VLBW) neonates with NEC in a middle-income setting.

Methods: A retrospective observational cohort study was conducted on all infants with birth weights less than 1501 g admitted from 2018 to 2020 at Groote Schuur Hospital, Cape Town, South Africa. Data were obtained from the Vermont Oxford Network and hospital folders.

Results: A total of 104/1582 (6.6%) neonates were diagnosed with NEC with a median onset of 8 days of life. The mortality rate was 39.0%, compared to the all-cause mortality rate of 18.7% for VLBW neonates. Thirty-two (32.0%) neonates with NEC were transferred for surgery of whom 10 (31.3%) died. Small for gestational age (p = 0.13), NEC stage 2B or above (p = 0,002), a positive blood culture (p = 0.018), a raised C-reactive protein (p = 0.013), hyponatraemia (p = 0.004), anaemia requiring blood transfusion (p = 0.003) and thrombocytopenia requiring platelet transfusion (p = 0.033) were associated with mortality. A positive blood culture was found in 37.0% with a predominance of Klebsiella pneumoniae isolates.

Conclusion: NEC has an early onset and a high mortality rate in our setting.

Keywords: low and middle income; mortality; necrotising enterocolitis; risk factors very low birth weight.

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References

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