Risk Factors For Necrotizing Enterocolitis In Small-for-gestational-age Infants:A Matched Case-control Study

Objective: Small-for-gestational-age(SGA)neonates were associated with increased incidence of necrotizing enterocolitis(NEC).However,few studies focused on the risk factors of the development of NEC in SGA infants.The purpose of this case-control study was to identify the risk factors of NEC in SGA newborns.Methods: This study included all SGA neonates admitted to the Neonatal Diagnosis and Treatment Center of Children’s Hospital of Chongqing Medical University during January 2008 to December 2016.Patients with NEC(Bell’s stage ≥II)were included in the NEC group.Controls were selected from the database during the same hospitalization and were matched for gestational age and birth weight.The risk factors associated with NEC were compared between two groups.Univariate and logistic regression models were used to investigate the potential risk factors.Results: During the study period,2,912 SGA infants were admitted to our institution and 97(3.33%)of whom developed NEC.A total of 90 cases were enrolled in the NEC group,and 180 controls were selected.Logistics regression analysis revealed that sepsis(β=1.542,OR=4.673,95%CI: 1.615-13.515,P=0.004)and anemia(β=0.790,OR=2.204,95%CI: 1.196-4.060,P=0.011)were independent risk factors of NEC in SGA newborns.Probiotics use(β=﹣1.310,OR=0.270,95%CI: 0.122-0.599,P=0.001)was identified as a protective factor of NEC.Conclusions: Sepsis and anemia were independent risk factors of NEC in SGA infants.Probiotics use was a protective factor of NEC in SGA infants.