Risk factors for necrotizing enterocolitis in very preterm infants: a case-control study in southwest China

Objective: The objective of this study is to investigate perinatal risk factors for necrotizing enterocolitis (NEC) in very preterm infants. Methods: This retrospective study included all preterm infants with a gestational age <32 weeks attending our institution from 2013 to 2016. The NEC group comprised patients with NEC enrolled according to the inclusion criteria. Controls were selected from the database and were matched for gender, gestational age, and birth weight. Enumeration data are expressed as percentages (%) and were compared using the chi(2) test. Quantitative data are expressed as the mean (standard deviation) and were compared using Student's t-test. Conditional logistic regression analyses were performed to identify the factors significantly associated with NEC. Results: During the study period, 945 very preterm infants were admitted to the neonatal intensive care unit, of whom 46 (4.87%) acquired NEC. A total of 33 cases were enrolled in the NEC group, and 33 controls were selected from the database. Univariate analyses revealed significant differences between groups in the incidence of maternal placenta previa, neonatal infection symptoms, septicemia, and intravenous aminophylline administration (p < .05). Conditional logistic regression analysis demonstrated statistically significant associations of neonatal septicemia (odds ratio [OR] = 4.000, p = .043) and intravenous aminophylline (OR = 4.922, p = .035) with NEC. Conclusion: Neonatal septicemia and intravenous aminophylline use are risk factors associated with NEC development in very preterm infants.