Article Text

Download PDFPDF

O-045 Incidence And Outcomes Of Severe Necrotising Enterocolitis In Infants Less Than 32 Weeks Gestation: A Prospective Population Study
  1. C Battersby,
  2. S Santhakumaran,
  3. N Modi,
  4. K Costeloe
  1. Neonatal Medicine, Imperial College London, London, UK


Objectives Population data for Necrotising Enterocolitis (NEC) are sparse. We determined the incidence, short-term outcomes and antecedent feed exposures of severe NEC in preterm infants in England.

Methods The study comprised infants 23+0 to 31+6 weeks gestation born in 2012 and admitted to 129 (80%) neonatal units in England. Infants with severe NEC (defined as requirement for surgery, histology, or post-mortem) were identified from the National Neonatal Research Database (

Results Of 6468 infants, 167 (2.6%) had severe NEC; incidence (95% confidence interval) for 23 to 25+6, 26 to 28+6, 29 to 31+6 weeks gestation infants was 8% (6.4, 10), 3.5% (2.7, 4.4) and 0.8% (0.6, 1.0) respectively. Relative Risk reduced with each additional gestational week (0.70 (0.66, 0.74); Poisson regression, p < 0.001). Of infants requiring surgery, 60% received surgery and survived, 30% received surgery and died, and 10% did not receive surgery; all died. Figure 1 illustrates the inverse relationship between gestation and postnatal age at surgery; median days (interquartile range) 23 to 25+6: 27 (13–44); 26 to 28+6:24 (11–35); 29 to 31+6:12 (8–25) (log-rank test, p = 0.02). Antecedent feeding exposures were 8% never fed; 41% exclusively maternal milk; 13% maternal and donor milk; 35% human milk and formula; 3% exclusively formula. Fortifier was used in 12%.

Conclusions Severe NEC remains a devastating disease affecting preterm infants in the first postnatal month. Novel findings are that 1 in 10 affected infants die having been considered too unwell for surgery, and over half were exclusively fed human milk prior to onset.

Abstract O-045 Figure 1

Postnatal age at NEC surgery.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.