Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study
Background: Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incide...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2020.00188/full |
| _version_ | 1818189004572459008 |
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| author | Carlos Zozaya Inés García González Alejandro Avila-Alvarez Niki Oikonomopoulou Tomás Sánchez Tamayo Enrique Salguero Miguel Saenz de Pipaón Miguel Saenz de Pipaón Fermín García-Muñoz Rodrigo María L. Couce María L. Couce |
| author_facet | Carlos Zozaya Inés García González Alejandro Avila-Alvarez Niki Oikonomopoulou Tomás Sánchez Tamayo Enrique Salguero Miguel Saenz de Pipaón Miguel Saenz de Pipaón Fermín García-Muñoz Rodrigo María L. Couce María L. Couce |
| author_sort | Carlos Zozaya |
| collection | DOAJ |
| description | Background: Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incidence, treatment, and mortality over the last decade in Spain.Methods: Multicenter cohort study with data from the Spanish Neonatal Network–SEN1500 database. The study period comprised from January 2005 to December 2017. Preterm infants <32 weeks of gestational age at birth without major congenital malformations were included for analysis. The main study outcomes were necrotizing enterocolitis incidence, co-morbidity (bronchopulmonary dysplasia, late-onset sepsis, cystic periventricular leukomalacia, retinopathy of prematurity, acute kidney injury), mortality, and surgical/non-surgical treatment.Results: Among the 25,821 included infants, NEC incidence was 8.8% during the whole study period and remained stable when comparing 4-year subperiods. However, more cases were surgically treated (from 48.8% in 2005–2008 to 70.2% in 2015–2017, p < 0.001). Mortality improved from 36.7% in the 2005–2008 to 26.6% in 2015–2017 (p < 0.001). Breastfeeding rates improved over the studied years (24.3% to 40.5%, p < 0.001), while gestational age remained invariable (28.5 weeks, p = 0.20). Prophylactic probiotics were implemented during the study period in some units, reaching 18.6% of the patients in 2015–2017.Conclusions: The incidence of necrotizing enterocolitis remained stable despite the improvement regarding protective factors frequency. Surgical treatment became more frequent over the study period, whereas mortality decreased. |
| first_indexed | 2024-12-11T23:35:56Z |
| format | Article |
| id | doaj.art-70417879420c464d865079fc90fbf9b2 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-11T23:35:56Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-70417879420c464d865079fc90fbf9b22022-12-22T00:45:52ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-05-01810.3389/fped.2020.00188523501Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort StudyCarlos Zozaya0Inés García González1Alejandro Avila-Alvarez2Niki Oikonomopoulou3Tomás Sánchez Tamayo4Enrique Salguero5Miguel Saenz de Pipaón6Miguel Saenz de Pipaón7Fermín García-Muñoz Rodrigo8María L. Couce9María L. Couce10Division of Neonatology, Hospital for Sick Children, Toronto, ON, CanadaNeonatology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela, A Coruña, SpainNeonatal Unit, Department of Paediatrics, Complexo Hospitalario Universitario A Coruña, Institute for Biomedical Research A Coruña, A Coruña, SpainDivision of Neonatology, Hospital for Sick Children, Toronto, ON, CanadaNeonatology Department, Malaga Regional Hospital, Malaga Biomedical Research Institute-IBIMA, Malaga, SpainNeonatology Department, Malaga Regional Hospital, Malaga Biomedical Research Institute-IBIMA, Malaga, SpainNeonatology Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Madrid, SpainRed Samid, Maternal and Child Health and Development Research Network, Carlos III Health Institute, Madrid, SpainDivision of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, SpainNeonatology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela, A Coruña, SpainRed Samid, Maternal and Child Health and Development Research Network, Carlos III Health Institute, Madrid, SpainBackground: Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incidence, treatment, and mortality over the last decade in Spain.Methods: Multicenter cohort study with data from the Spanish Neonatal Network–SEN1500 database. The study period comprised from January 2005 to December 2017. Preterm infants <32 weeks of gestational age at birth without major congenital malformations were included for analysis. The main study outcomes were necrotizing enterocolitis incidence, co-morbidity (bronchopulmonary dysplasia, late-onset sepsis, cystic periventricular leukomalacia, retinopathy of prematurity, acute kidney injury), mortality, and surgical/non-surgical treatment.Results: Among the 25,821 included infants, NEC incidence was 8.8% during the whole study period and remained stable when comparing 4-year subperiods. However, more cases were surgically treated (from 48.8% in 2005–2008 to 70.2% in 2015–2017, p < 0.001). Mortality improved from 36.7% in the 2005–2008 to 26.6% in 2015–2017 (p < 0.001). Breastfeeding rates improved over the studied years (24.3% to 40.5%, p < 0.001), while gestational age remained invariable (28.5 weeks, p = 0.20). Prophylactic probiotics were implemented during the study period in some units, reaching 18.6% of the patients in 2015–2017.Conclusions: The incidence of necrotizing enterocolitis remained stable despite the improvement regarding protective factors frequency. Surgical treatment became more frequent over the study period, whereas mortality decreased.https://www.frontiersin.org/article/10.3389/fped.2020.00188/fullnecrotizing enterocolitispreterm infantmortalitymorbiditytrends |
| spellingShingle | Carlos Zozaya Inés García González Alejandro Avila-Alvarez Niki Oikonomopoulou Tomás Sánchez Tamayo Enrique Salguero Miguel Saenz de Pipaón Miguel Saenz de Pipaón Fermín García-Muñoz Rodrigo María L. Couce María L. Couce Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study Frontiers in Pediatrics necrotizing enterocolitis preterm infant mortality morbidity trends |
| title | Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study |
| title_full | Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study |
| title_fullStr | Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study |
| title_full_unstemmed | Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study |
| title_short | Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study |
| title_sort | incidence treatment and outcome trends of necrotizing enterocolitis in preterm infants a multicenter cohort study |
| topic | necrotizing enterocolitis preterm infant mortality morbidity trends |
| url | https://www.frontiersin.org/article/10.3389/fped.2020.00188/full |
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