Abstract
Typically, neonatal necrotizing enterocolitis (NEC) occurs in the premature infant, but about 10% of those affected with the condition are full-term. About half of these have coexisting risk factors. Specific congenital abnormalities, particularly congenital heart disease, are known to increase the likelihood of developing NEC, and mostly these are indicative of some form of perinatal stress. Nevertheless, the most common comorbidity in NEC remains prematurity and its sequelae.
This chapter reviews some of the characteristics and implications of Neonatal necrotizing enterocolitis (NEC) when it occurs in term infants. It provides a summary of some of the conditions that have an apparent association with NEC, and the purported contributing factors for NEC in both preterm and full-term infants are listed. NEC is generally considered a disease that affects the premature infant, particularly where the preterm neonate has been exposed to significant perinatal stress. However, it can also occur in full-term infants, for which only about half have recognizable contributing risk factors. In logistic regression analysis, peritonitis and renal failure appear to be predictors of mortality in early-onset enterocolitis, and peritonitis and respiratory failure are significant predictors of mortality in late-onset NEC in full-term infants. The overall mortality in both groups was similar in this review of 253 infants with NEC of 37 weeks' gestation.