Necrotizing enterocolitis in preterm infants with poor outcome: causes, risk factors for mortality, histological changes of the intestinal lining

Despite advances in the diagnosis and treatment of necrotizing enterocolitis (NEC), associated morbidity mortality rates remain high. Purpose - to establish risk factors for preterm born infants, as well analyze histological changes intestinal lining. Materials methods. The course NEC 21 neonates who died this disease (group 1, n=21) over a period 3 years was analyzed. To rate health indicators children group 1 were compared with survived similar stages 2, n=43). following research methods used: general clinical, laboratory, instrumental, statistical. Results. Our data show that main causes severe infants is infection, often combination asphyxia. identified allowed death with: male sex (OR=4.675; χ2=7.679; p=0.006) increases by 4 time; inflammatory placenta (OR=6.139; χ2=10.501; p=0.002) 6 times; red blood cell transfusion (OR=8.262; χ2=8.557; p=0.004) 8 thrombocytopenia (OR=4.320; χ2=4.866; p=0.028) developmen multiple organ system failure (OR=12.364; χ2=17.578; p<0.001) DIC syndrome (OR=10.725; χ2=14.592; 12 11 times, respectively; positive symptoms oedema anterior abdominal wall (OR=14.025; χ2=19.258; vasodilation l (OR=5.333; χ2=5.444; p=0.02) 14 5 pneumatosis on when x-ray detected (OR=6.840; χ2=6.867; p=0.009) peritoneal effusion ultrasound (OR=8.750; χ2=14.448; 7 9 respectively. During examination lymphohistiocytic infiltration submucosa indicates perinatal hypoxia its crucial role thanatogenesis disease, while polymorphonuclear segmental neutrophil infection. In 15 (71.4%) both types noted, which mixed etiology lesions. Conclusions. Study results confirmed serious newborns high rate. forms occur against background infection hypoxia. obtained allow improve prognosis will provide an opportunity identify need increased attention doctors further management these patients use preventive technologies can prevent catastrophic consequences. presence congenital defects premature birth contribute development aggravate NEC, up stage III negative disease. carried out accordance principles Helsinki Declaration. study protocol approved Local ethics committee all participating institutions. informed consent parents patient conducting studies. No conflict interests declared authors. Key words: enterocolitis, neonates, mortality, changes.