SURVIVAL AFTER NECROTIZING ENTEROCOLITIS IN INFANTS WEIGHING LESS-THAN 1,000 G - 25 YEARS EXPERIENCE AT A SINGLE INSTITUTION

Necrotizing enterocolitis (NEC) primarily affects premature newborns. Regional and national decreases in the mean birthweight and gestationa l age of neonatal intensive care unit (NICU) admissions prompted a rev iew of NEC in VLBW (very low birth weight, defined as <1,000 g) infant s in our institution over a 25-year period. There were 266 patients tr eated for NEC during the study interval. We compared 71 VLBW with 195 non-VLBW infants and found that VLBW infants were: fed later (6.4 days v 4.1 days, P = .009), developed NEC later (20.8 days v 13.1 days, P = .002), had significantly lower 1- and 5-minute Apgar scores, were mo re likely to require surgery (51% v 34%, P = .016), more often had pan intestinal (defined as >75% of intestinal length) involvement (10% v 4 %, P = .043), and had poorer survival (56% v 72%, P = .013). Overall s urvival after NEC has improved over the study interval, both in our se ries and in other reports. However, the increasing number of VLBW infa nts who have NEC represent a subgroup who appear to be generally more ill, develop NEC later, require surgery with greater frequency than th eir non-VLBW counterparts, and are less likely to survive. Copyright ( C) 1997 by W.B. Saunders Company.