Necrotizing enterocolitis in term neonates: Possible risk factors
DOI:
https://doi.org/10.47338/jns.v9.537Keywords:
Necrotizing enterocolitis, NEC, Term, Neonates, Risk factors, MethamphetamineAbstract
Background: Necrotizing enterocolitis (NEC) is a common surgical disease in premature neonates, however, it may occasionally occur in term neonates. The etiology of NEC in prematurity is multifactorial but is still not well understood in term neonates. In this study, the maternal and neonatal risk factors, along with underlying pathology that may precipitate NEC in term neonates are investigated.
Methods: A retrospective study investigating the maternal and neonatal risk factors for NEC in term neonates (G.A ≥37 weeks) was performed over an 8-years period (January 2009 to March 2017). We used the second group of healthy term neonates over the same period as a control group. The data were collected from medical records. Term babies with the primary diagnosis of NEC were included in the review. Premature neonates (G.A <37 weeks) and NEC secondary to intestinal obstruction (e.g. Hirschsprung’s disease) were excluded from the study.
Results: Of 194 babies with NEC, 14 were term neonates. Maternal risk factors: maternal age, Rhesus status, nicotine use, medication use, chronic and gestational illness were not found to be significant, however, maternal methamphetamine (MA) abuse was found to be a significant risk factor. Neonatal risk factors: genetic disorder, mode of delivery, type of milk, and invasive procedure were not found to be significant, but the presence of congenital heart disease (CHD) was a significant risk factor. Three neonates with CHD (3/4) in the group of term neonates with NEC also had maternal MA use.
Conclusion: NEC in term neonates is rarely encountered. CHD is well known to precipitate the disease in premature or full-term neonates, as also noted in this cohort. MA usage was also noted as a possible underlying cause.
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Gupta A, Paria A. Etiology and medical management of NEC. Early Hum Dev. 2016; 97:17–23.
Thakkar HS, Lakhoo K. The surgical management of necrotising enterocolitis (NEC). Early Hum Dev. 2016; 97:25–8.
Raboel EH. Necrotizing enterocolitis in full-term neonates: Is it aganglionosis? Eur J Pediatr Surg. 2009; 19:101–4.
Overman RE, Criss CN, Gadepalli SK. Necrotizing enterocolitis in term neonates: A different disease process? J Pediatr Surg. 2019; 54:1143–6.
De La Cochetière MF, Piloquet H, Des Robert C, Darmaun D, Galmiche JP, Rozé JC. Early intestinal bacterial colonization and necrotizing enterocolitis in premature infants: The putative role of Clostridium. Pediatr Res. 2004; 56:366–70.
Maayan-Metzger A, Itzchak A, Mazkereth R, Kuint J. Necrotizing enterocolitis in full-term infants: Case-control study and review of the literature. J Perinatol. 2004; 24:494–9.
Ostlie DJ, Spilde TL, St Peter SD, Sexton N, Miller KA, Sharp RJ, et al. Necrotizing enterocolitis in full-term infants. J Pediatr Surg. 2003; 38:1039–42.
Bolisetty S. A regional study of underlying congenital diseases in term neonates with necrotizing enterocolitis. Acta Paediatr. 2000; 89:1226–30.
McElhinney DB, Hedrick HL, Bush DM, Pereira GR, Stafford PW, Gaynor JW, et al. Necrotizing enterocolitis in neonates with congenital heart disease: Risk factors and outcomes. Pediatrics. 2000; 106):1080–7.
Tik - the only product costing you less [Internet]. [cited 2020 Jun 12]. Available from: https://www.iol.co.za/news/tik-the-only-product-costing-you-less-1927489
Community Intervention Centre | Trauma Psychology in Cape Town, Western Cape, South Africa [Internet]. [cited 2020 Jun 12]. Available from: http://www.blaauwberg.net/cic/articles/drugs/cocaine.asp
Drug dealers are making as much as R4,000 a day from South Africa’s growing heroin epidemic [Internet]. [cited 2020 Jun 12]. Available from: https://businesstech.co.za/news/lifestyle/310786/drug-dealers-are-making-as-much-as-r4000-a-day-from-south-africas-growing-heroin-epidemic/
Vearrier D, Greenberg MI, Miller SN, Okaneku JT, Haggerty DA. Methamphetamine: history, pathophysiology, adverse health effects, current trends, and hazards associated with the clandestine manufacture of methamphetamine. Disease-a-Month. 2012; 58:38–89.
Prakash MD, Tangalakis K, Antonipillai J, Stojanovska L, Nurgali K, Apostolopoulos V. Methamphetamine: Effects on the brain, gut and immune system. Vol. 120, Pharmacological Research. Academic Press; 2017. p. 60–7.
Attaran H. Fatal Small intestinal ischemia due to methamphetamine intoxication: Report of a case with autopsy results. Acta Med Iran. 2017; 55:344–7.
Garcia-Bournissen F, Rokach B, Karaskov T, Koren G. Methamphetamine detection in maternal and neonatal hair: Implications for fetal safety. Arch Dis Child Fetal Neonatal Ed. 2007; 92.F351-5.
Nora J, Vargo T, Nora A, Love K, Mcnamara D. Dexamphetamine: a possible environmental trigger in cardiovascular malformations. The Lancet. 1970; 295:1290-1.
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