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183 Prevention of Necrotising Enterocolitis
  1. S Patole1,2
  1. 1Neonatal Paediatrics, KEM Hospital for Women
  2. 2Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia

Abstract

Necrotising enterocolitis (NEC) is a potentially disastrous illness that occurs in 6–8% of preterm (gestation < 32 weeks) very low birth weight neonates. The mortality (~25%) and morbidity of ≥ Stage II NEC (e.g. need for surgery, survival with short bowel syndrome with protracted feed intolerance, complications of prolonged dependence on parenteral nutrition, recurrent infections, and prolonged hospital stay) is significant. The incidence (10–12%), mortality (40–45%), and morbidity including need for surgery, and risk of long-term neurodevelopmental impairment after surviving surgery for NEC is worse in extremely low birth weight neonates. The economic burden of NEC is substantial (~500 million to 1 billion dollars per year in the USA) considering the prolonged hospital stay due to the associated complications. NEC has become one of the common causes of death in preterm neonates surviving the first week of life. The pathogenesis of NEC remains poorly understood despite decades of research. Prevention of prematurity, the single most important risk factor for the illness, has proved to be a difficult task. The absolute number of preterm neonates at risk for the illness has increased with advances in neonatal intensive care. Prevention of NEC has thus become a priority. The well established (e.g. antenatal glucocorticoids, early preferential feeding with breast milk, standardised feeding protocols) as well as newer strategies (e.g. probiotics, prebiotics) for primary as well as potentially secondary (e.g. pentoxifylline, bosentan) prevention of NEC will be reviewed.

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