Risk factors for Necrotizing enterocolitis in very low birth weight infants at Nongkhai Hospital

Abstract

Necrotizing enterocolitis (NEC) is a critical gastrointestinal emergency in neonates, particularly those born preterm, with incidence varying across populations. Prematurity and low birth weight are well established major risk factors, while additional contributors reported in previous studies include perinatal hypoxia, formula feeding, apnea, central venous catheterization, and polycythemia. This study aimed to identify risk factors associated with NEC in very low birth weight (VLBW) infants (birth weight < 1,500 g) admitted to the neonatal intensive care unit (NICU) at Nong Khai Hospital. A total of 167 VLBW infants were included, of whom        25 developed NEC. Data were analyzed using univariate analysis, with variables showing p<0.20 further evaluated via multivariate logistic regression; statistical significance was set at p<0.05. Univariate analysis identified seven potential risk factors: premature rupture of membranes, sepsis, ventilator- associated pneumonia, umbilical arterial catheterization, blood transfusion, mechanical ventilation, and patent ductus arteriosus. Multivariate analysis revealed that only blood transfusion was independently associated with NEC (adjusted OR 6.13, 95% CI: 1.23–30.47, p=0.01). These findings underscored the importance of careful evaluation of transfusion requirements in VLBW infants and vigilant monitoring for NEC following each transfusion or administration of blood components.