ArticlePediatric research2025
Surgical necrotizing enterocolitis risk factors in extremely preterm infants: a Korean nationwide cohort study.
Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed.
- Bifidobacterium modulates gut microbiota and aryl hydrocarbon receptor signaling in necrotizing enterocolitis rat model.Pediatric research · 2026Article
- Comparison of imaging findings of surgical necrotizing enterocolitis between extremely preterm and preterm infants.Pediatric radiology · 2026Article
- Necrotizing enterocolitis is exacerbated through SUCNR1/HIF-1α/BNIP3 axis-mediated succinate-induced intestinal epithelial cell apoptosis.Pediatric research · 2026Article
- Neonatal Intensive Care Admissions and Outcomes in Malta from 2019 to 2022-A Retrospective Observational Study.Children (Basel, Switzerland) · 2026Article
- Surgical Necrotising Enterocolitis (S-NEC): Where We Stand Today: A Narrative Review.Journal of clinical medicine · 2026Review
- Observational
- Risk factors of necrotizing enterocolitis in very low birth weight infants: a meta-analysis.Frontiers in pediatrics · 2026Review
- Increased incidence of necrotizing enterocolitis in very/extremely preterm infants with early hypotension: a retrospective cohort study.Translational pediatrics · 2025Article
- Impact of Delivery Mode on Neonatal Outcomes in Extremely Preterm Infants Born at 22 + 0 to 25 + 6 Weeks of Gestation.Medicina (Kaunas, Lithuania) · 2025Article
- SecureEdge-MedChain: A Post-Quantum Blockchain and Federated Learning Framework for Real-Time Predictive Diagnostics in IoMT.Sensors (Basel, Switzerland) · 2025Article
- The fifty billion dollar question: does formula cause necrotizing enterocolitis?Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Necrotizing enterocolitis: perspectives from a population-based study.Pediatric research · 2025Article
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3 authors.
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Abstract
backgroundThe incidence of necrotizing enterocolitis (NEC) is significantly associated with gestational age (GA). This study aimed to investigate risk factors for surgically treated NEC (sNEC) in extremely preterm infants (EPIs) using nationwide cohort registry.
methodsData were collected from 16,338 very-low-birth-weight infants registered in the Korean neonatal network. Clinical data of 5310 EPIs were retrospectively analyzed. sNEC was defined as infants with diagnosis of NEC requiring surgical treatment, who underwent surgical intervention for NEC or died before surgery. Infants were categorized into three groups based on their NEC status: infants without NEC (control), medically treated NEC (mNEC), and sNEC. These groups were matched based on GA to investigate risk factors for NEC.
resultsIn EPIs, small for gestational age (SGA; odds ratio 1.68, 95% confidence interval [CI], 1.17-2.36, p = 0.004), hypotension (1.49, 1.18-1.89, p = 0.001), and IVH (1.63, 1.30-2.05, p < 0.001) were identified as risk factors for sNEC. Complete administration of antenatal steroid reduced the risk of sNEC (0.80, 0.64-0.99, p = 0.044).
conclusionOur study demonstrated that EPIs who are SGA, and experience hypotension and IVH may be at an increased risk of developing NEC requiring surgery. These groups require close attention and monitoring for any signs of surgical indications of NEC. IMPACT: This nationwide cohort study aimed to identify characteristics of infants with necrotizing enterocolitis (NEC) among extremely preterm infants (EPIs) and analyze the risk factors associated with NEC requiring surgical intervention. Small for gestational age (SGA), hypotension, and intraventricular hemorrhage (IVH) were identified as significant risk factors for surgically treated NEC (sNEC) in EPIs. The administration of antenatal steroids decreases the risk of sNEC. Close attention and monitoring for EPIs with early identifiable risk factors such as SGA, hypotension, and IVH should be considered to prevent and detect sNEC early, ultimately leading to improved long-term outcomes.
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