Risk factors for necrotizing enterocolitis in preterm infants: a Meta analysis

LU Chun-Yun, LIU Ke-Feng, QIAO Gao-Xing, LUO Yuan, CHENG Hui-Qing, DU Shu-Zhang

Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (8) : 908-916.

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Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (8) : 908-916. DOI: 10.7499/j.issn.1008-8830.2202085
CLINICAL RESEARCH

Risk factors for necrotizing enterocolitis in preterm infants: a Meta analysis

  • LU Chun-Yun, LIU Ke-Feng, QIAO Gao-Xing, LUO Yuan, CHENG Hui-Qing, DU Shu-Zhang
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Abstract

Objective To systematically evaluate the risk factors for necrotizing enterocolitis (NEC) in preterm infants. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data were searched for case-control studies and cohort studies on the risk factors for NEC in preterm infants published up to December 2021. RevMan 5.3 software was used to perform the Meta analysis. Results A total of 38 studies were included (28 case-control studies and 10 cohort studies). The Meta analysis showed that maternal gestational diabetes (OR=2.96, P<0.001), intrahepatic cholestasis during pregnancy (OR=2.53, P<0.001), preeclampsia (OR=1.73, P=0.020), history of neonatal asphyxia (OR=2.13, P<0.001), low gestational age (OR=1.23, P=0.010), sepsis (OR=5.32, P<0.001), patent ductus arteriosus (OR=1.57, P=0.001), congenital heart disease (OR=3.78, P<0.001), mechanical ventilation (OR=2.23, P=0.020), history of antibiotic use (OR=1.07, P<0.001), use of vasopressors (OR=2.34, P=0.040), and fasting (OR=1.08, P<0.001) were risk factors for NEC in preterm infants, while cesarean section (OR=0.73, P=0.004), use of pulmonary surfactant (OR=0.43, P=0.008), and breastfeeding (OR=0.24, P=0.020) were protective factors against NEC. Conclusions Maternal gestational diabetes, intrahepatic cholestasis during pregnancy, preeclampsia, low gestational age, fasting, sepsis, patent ductus arteriosus, congenital heart disease, and histories of asphyxia, mechanical ventilation, antibiotic use, and use of vasopressors may increase the risk of NEC in preterm infants, while cesarean section, use of pulmonary surfactant, and breastfeeding may decrease the risk of NEC in preterm infants.

Key words

Necrotizing enterocolitis / Risk factor / Meta analysis / Preterm infant

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LU Chun-Yun, LIU Ke-Feng, QIAO Gao-Xing, LUO Yuan, CHENG Hui-Qing, DU Shu-Zhang. Risk factors for necrotizing enterocolitis in preterm infants: a Meta analysis[J]. Chinese Journal of Contemporary Pediatrics. 2022, 24(8): 908-916 https://doi.org/10.7499/j.issn.1008-8830.2202085

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