Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study.

Background: Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups.

Methods: Risk factors associated with NEC were investigated using a retrospective case-control design. Patients with Bell's Stage NEC≥II were divided into three groups based on GA: I, <34 weeks; II, ≥34 weeks but <37 weeks; III, ≥37 weeks. Each case was paired with two GA- and weight-matched controls. Data were collected from medical records, and univariate and conditional logistic regression analyses employed.

Results: A total of 238 cases and 476 controls were enrolled. Variation in the months when NEC was diagnosed was noted, with a peak in January and a trough in August. Intrahepatic cholestasis of pregnancy and transfusion with packed red blood cells were significantly associated with NEC in preterm infants. Meconium aspiration syndrome was an independent risk factor for a greater chance of NEC development in full-term infants. Postnatal asphyxia and sepsis were associated with an increased risk of NEC in all groups. Probiotic use was associated with a reduced risk of NEC. Patients aged >34 weeks with congenital heart disease were more likely than controls to have NEC.

Conclusion: Intrahepatic cholestasis of pregnancy and meconium aspiration syndrome may be new risk factors for NEC.