ArticlePediatric surgery international2026
Two faces of necrotizing enterocolitis: early and late-onset disease in preterm infants.
Article in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhether early-onset (EO-NEC) and late-onset necrotizing enterocolitis (LO-NEC) represent distinct entities remains debated. We compared clinical presentation, radiologic features, and surgical outcomes.
methodsIn this retrospective study (2013-2023), neonates with Bell stage II-III NEC were stratified into EO-NEC (< 14 days) and LO-NEC (≥ 14 days).
resultsFifty-seven infants were included: 37 (64.9%) EO-NEC and 20 (35.1%) LO-NEC. EO-NEC was associated with higher birth weight (1611 ± 767 vs. 1111 ± 377 g; p = 0.0017) and gestational age (31.4 ± 4.5 vs. 29.3 ± 2.7 weeks; p = 0.033). LO-NEC occurred more frequently in very-low-birth-weight infants (55% vs. 8%; p < 0.001) and showed higher rates of portal venous gas (70% vs. 30%; p = 0.005) and indomethacin-treated PDA (25% vs. 2.7%; p = 0.031). Intestinal perforation occurred exclusively in EO-NEC (27%; p = 0.01). Surgical intervention rates, intestinal resection lengths, and mortality were comparable.
conclusionsEO-NEC and LO-NEC differ in infant maturity and perinatal exposures but not in overall severity or mortality.
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