A retrospective case-control study of necrotizing enterocolitis (NEC) was conducted among infants weighing greater than 2,000 g at birth. Twenty-three infants met the NEC criteria for inclusion in the study; 12 weighed 2,001 to 2,500 g at birth and 11 weighed greater than 2,500 g at birth. Hypoglycemia occurred in 7/12 (55%) infants weighing 2,001 to 2,500 g and in 4/35 (11%) control subjects (P less than .02). In infants weighing greater than 2,500 g at birth, polycythemia (occurring in 7/12 study infants (58%) and 5/32 (16%) control infants) and respiratory distress (3/11 study infants (27%) and 0 control subjects) were significantly associated with NEC (P less than .02). Larger infants with a history of perinatal stress and/or physiologic immaturity are likely to be at greater risk for NEC than their normal counterparts.

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