Risk factors for necrotizing enterocolitis in neonates: A meta-analysis

Yan Su; Rui-Hong Xu; Li-Yan Guo; Xin-Qing Chen; Wen-Xiao Han; Jin-Jin Ma; Jiao-Jiao Liang; Ling Hao; Chang-Jun Ren

doi:10.3389/fped.2022.1079894

Risk factors for necrotizing enterocolitis in neonates: A meta-analysis

Front Pediatr. 2023 Jan 6:10:1079894. doi: 10.3389/fped.2022.1079894. eCollection 2022.

Authors

Yan Su¹, Rui-Hong Xu¹, Li-Yan Guo¹, Xin-Qing Chen¹, Wen-Xiao Han¹, Jin-Jin Ma¹, Jiao-Jiao Liang¹, Ling Hao¹, Chang-Jun Ren¹

Affiliation

¹ Department of Pediatrics, The First Hospital of Hebei Medical University, Shijiazhuang, China.

Abstract

Objective: The objective is to identify the risk factors for necrotizing enterocolitis (NEC) in neonates by a meta-analysis, and to provide a reference for the prevention of NEC.

Methods: The databases, including Chinese Biomedical Literature Datebase, China National Knowledge Infrastructure, Wanfang database, and Weipu Periodical database, PubMed, Web of Science, Embase, Cochrane Library, were searched for studies on the risk factors for NEC in neonates. The meta-analysis was carried out with the aid of Stata software.

Results: A total of 52 studies were included, with 48 case-control studies and 4 cohort studies. There were 166,580 neonates in total, with 33,522 neonates in the case group and 133,058 neonates in the control group. The meta-analysis showed that gestational diabetes (OR = 3.62, 95% CI:1.77-7.41), premature rupture of membranes (OR = 3.81, 95% CI:1.16-12.52), low birth weight (OR = 3.00, 95% CI:2.26-3.97), small for gestational age (OR = 1.85, 95% CI:1.15-2.97), septicemia (OR = 4.34, 95% CI:3.06-6.15), blood transfusion (OR = 3.08, 95% CI:2.16-4.38), congenital heart disease (OR = 2.73, 95% CI:1.10-6.78), respiratory distress syndrome (OR = 2.12, 95% CI:1.24-3.63), premature birth (OR = 5.63, 95% CI:2.91-10.92), pneumonia (OR = 4.07, 95% CI:2.84-5.82) were risk factors for NEC in neonates. Breastfeeding (OR = 0.37, 95% CI:0.23-0.59), take probiotics (OR = 0.30, 95% CI:0.22-0.40), prenatal use of glucocorticoids (OR = 0.39, 95% CI:0.30-0.50), Hyperbilirubinemia (OR = 0.28, 95% CI:0.09-0.86) were protective factors for NEC in neonates.

Conclusions: Gestational diabetes, premature rupture of membranes, low birth weight, small for gestational age, septicemia, blood transfusion, congenital heart disease, respiratory distress syndrome, premature birth, and pneumonia may increase the risk of NEC in neonates. Breastfeeding, taking probiotics, prenatal use of glucocorticoids, and Hyperbilirubinemia may reduce the risk of NEC in neonates.

Keywords: meta analysis; necrotizing enterocolitis; neonate; newborn; risk factor.

Publication types

Review