Abstract

NEC is one of the most important surgical disease in the first few days after birth. The aim of this study is to describe incidence of Necrotizing enterocolitis in multiple gestations compared with singletons, determining the neonatal outcome, risk factors and co-morbid factors.

A retrospective review of the discharge records of multiple-gestation and singletons infants admitted into the neonatal intensive care units between January 2002 and January 2009 was performed.

The medical charts of all infants developing NEC or suspected NEC were reviewed and perinatal data recorded. The risk and co-morbid factors of two main groups (developing NEC and not developing NEC) were analyzed.

During the study period we considered 409 infants from multiple gestations and 895 singletons. The percentage of infants with NEC in multiple gestation (18%) was higher than singleton prematurity at the same Hospital (4%) (p<0.05). Patients with suspected or advanced NEC showed longer time of meconium evacuation if compared to the others (mean 5 vs. 2 days, p<0.05). Patients who received bowel enemas starting from day 2 after birth did not developed NEC or advanced NEC (p<0.05). Mortality was associated with lower gestational age and lower Apgar score at 1 minute (p<0.05).

The analysis of multiple pregnancies showed that the incidence of NEC(stage II but Stage III) increased with respect to singleton pregnancies only when considered in relation to a higher prematurity rate.