A recent systematic review (IH Jones, NJ Hall. J Pediatr 2020; 220: 86-92) provides contemporary outcomes for infants with necrotizing enterocolitis (NEC). The authors analyzed from 38 articles (from 1375 abstracts); the authors excluded data from developing countries. This review included 21,349 infants with any stage of NEC and 7540 with Bell stage 2a+.
- Overall mortality was 23.5% in all neonates with confirmed NEC (Bell stage 2a+), 34.5% for infants who underwent surgery
- Mortality rates were higher for extremely low birthweight infants (<1000 g) at 40.5%; the rate was 50.9% for surgical NEC in this cohort
- Neurodevelopmental disability was reported in only 4 studies and ranged between 24.8% and 61.1% (n=1209)
- Intestinal failure was reported with an incidence of 15.2% to 35.0% (n=1370)
A limitation with this study is the lack of agreement on definitions/diagnosis for necrotizing enterocolitis and intestinal failure.
My take: This study shows that NEC still carries a high mortality.
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- Impact of Maternal Antibiotics on NEC and Death in Neonates
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