Abstract

BACKGROUND: Necrotizing Enterocolitis (NEC) is the most common gastrointestinal emergency affecting newborn infants. Because the onset of NEC is often sudden and its progression rapid, improved clinical and biological predictors of NEC would augment the care of affected infants. OBJECTIVE: To investigate the relationship between selected clinical factors and NEC diagnosis. DESIGN/METHODS: Case-control study of 198 premature infants: 99 infants with NEC and gestational age (GA)-matched controls. The diagnosis of NEC, as defined by Bell stages I-IIIB, was required for assignment to the case group. The relationship between 21 clinical variables and NEC was assessed via non-parametric analyses. RESULTS: A significant increase in risk of developing NEC was found when the first feeding is not breast milk compared to those fed breast milk [OR=1.97, 95% CI 1.07, 3.63].Stooling pattern during the first post natal week varied on mean (p=.017) and max (p=.036) number of stools per day. On average, infants who developed medical NEC had a greater number of stools per day during the first postnatal week when compared to the stooling pattern of controls. CONCLUSIONS: This analysis provides additional support for breast milk as a protective factor for NEC and suggests that the stooling pattern during the first postnatal week is a potential indicator of disease severity. Further study of the infant stooling pattern as a predictor of NEC is warranted.