Preterm births constituted 7.6% of live births in 2007 in the Netherlands (http://www.
perinatreg.nl). In the United States, premature infants comprised 12.8% of live births
and the incidence of premature live births is rising because of the improved perinatal
care. With the rising incidence of preterm births and the improving survival rates of (extremely)
very low birth weight neonates, efforts to decrease morbidity concerning short
and long term outcome remain a challenge in the neonatal intensive care unit (NICU).
Necrotizing enterocolitis (NEC) is the most common surgical emergency involving the
gastrointestinal tract of preterm neonates and affects 2-7% of all premature infants.
Both the incidence of NEC and its fatality rate are inversely related to birth weight and
gestational age.
Treatment is still limited to immediate restriction of enteral feeds and broad-spectrum
antibiotics. Although most cases of NEC are managed medically, an estimated 20-40%
of infants undergo surgery. Mortality rates from NEC range from 15-30% but mortality
rates for infants requiring surgery are as high as 50%, and are highest for the smallest,
most immature infants. Survivors of NEC are at increased risk for complications such
as short bowel syndrome and impaired neurodevelopment. Stoll and colleagues
reported that between 18 and 22 months of corrected gestational age, infants who
recovered from NEC in the postnatal period were at high risk for adverse outcomes,
including poor growth, cerebral palsy, vision and hearing impairment, and decreased
neuromotor development. Furthermore, infants who are surgically treated are more
likely to have growth impairment and adverse neurodevelopmental outcomes than
infants who were treated medically.http://repub.eur.nl/res/pub/26828/101222_Puiman%2C%20Patricja%20Jolanta.pdf
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