Risk factors for necrotizing enterocolitis in neonates:a prospective study


  • Manas Ranjan Sahoo Department of Pediatrics, ASRAM Medical College, Eluru, Andhra Pradesh, India
  • Pydi Nagasree Department of Pediatrics, ASRAM Medical College, Eluru, Andhra Pradesh, India
  • Lanka Swetha Department of Pediatrics, ASRAM Medical College, Eluru, Andhra Pradesh, India
  • Arigela Vasundhara Department of Pediatrics, ASRAM Medical College, Eluru, Andhra Pradesh, India




Gestational diabetes mellitus, Necrotising enterocolitis, New Ballard score, Pregnancy induced hypertension, Prematurity


Background: Necrotizing enterocolitis (NEC) is mostly limited to preterm babies due to immaturity of gut. NEC is one of important cause of neonatal mortality and morbidity in the neonatal intensive care units all over the world.

Aim of study is to find the antenatal and post-natal risk factors associated with necrotizing enterocolitis in neonates admitted to NICU.

Methods: A prospective study was conducted on 45 neonates with necrotizing enterocolitis fulfilling the predetermined inclusion criteria. A detailed antenatal history including all maternal risk factors, birth history including the need for resuscitation and type of resuscitation was recorded. The gestational assessment was done by the New Ballard Score.

Results: Pregnancy induced hypertension accounts as a risk factor to most of the cases of NEC 18 (40%), followed by setting for sepsis 12 (26.6%), least being gestational diabetes mellitus 1 (2.2%).

Conclusions: Prematurity is found to be the most common risk factor followed by patent ductus arteriosus and sepsis. Most common antenatal risk factor was PIH (Pregnancy induced hypertension).


Amoury R, Godwin C, McGill C. Necrotizing enterocolitis following operation in the neonatal period. J Pediatr Surg. 1980:15(1);1-8.

Ball T, Wyly J. Enterocyst formation: a late complication of neonatal necrotizing enterocolitis. Am J Roentgenol. 1986:147(4):806-08.

Ballance WA, Dahms BB, Shenker N, Kliegman RM. Pathology of neonatal necrotizing enterocolitis: a ten-year experience. J Pediatr. 1990;117(1):S6-13.

Bell MJ, Ternberg JL, Feigin RD. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg. 1978;187(1):1-7.

Ballard JL, Khoury JC, Wedig K. New ballard score, expanded to include extremely premature infants. J Pediatrics. 1991;119:417-23.

Blakey JL, Lubitz L, Barnes GL, Bishop RF, Campbell NT, Gillam GL. Development of gut colonisation in pre-term neonates. J Med Microbiol. 1982:15(4);519-29.

Guthrie S, Phillip V l: Necrotising enterocoloitis among neonates in United States. J Perinatal. 2003;23(4):278-85.

Coit AK. Necrotizing enterocolitis. J Perinatl Neonatal Nurs. 1999;12(4):53-66.

Stoll BJ. Epidemiology of necrotizing enterocolitis. Clin Perinatol. 1994;21:205-18.

Kosloske AM. Epidemiolgy of necrotizing enterocolitis. Acta Paediatr. 1994;396:2-7.

Chandler JC, Hebra A. Necrotizing enterocolitis in infants with very low birth weight. Semin Pediatr Surg. 2000;9(2):63-72.

Boo NY, Cheah GS. Risk factors associated with necrotising enterocolitis in very low birth weight infants in Malaysian neonatal intensive care units. Singapore Med J. 2012;53(12): 826-31.

Buch NA, Ahmad SM, Ali SW, Hassan HM: an epidemiological study of neonatal necrotizing enterocolitis. Saudi Med J. 2001;22(3):231-7.

Beeby PJ, Jeffery H. Risk factors for necrotising enterocolitis: the influence of gestational age. Arch Dis Childhood. 1992;67(4):432-35.

Qian T, Zhang R. Necrotizing enterocolitis in low birth weight infants in China: mortality risk factors expressed by birth weight categories. Pediatr Neonatol. 2017;58(6)509-15.

Narang A, Rao R, Bhakoo ON. Neonatal necrotizing enterocolitis: an epidemiological study. Indian Pediatr. 1993;30(10):1207-14.

Bombell S, McGuire W. Delayed introduction of progressive enteral feeds to prevent necrotizing enterocolitis in very low birth weight infants. Cochrane Database Sys Rev. 2008(2).

Thomas C, Krishnan L. Neonatal necrotising enterocolitis. Indian Pediatr. 1997;34:47-50.






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