Risk Factors for Necrotizing Enterocolitis among Palestinian Premature and Neonates: A Retrospective study رسالة ماجستير

Abstract

Background: Necrotizing Enterocolitis is the most common gastrointestinal emergency in premature and neonates admitted to the neonatal intensive care unit. The most prevalent potentially fatal illness affecting the gastric tract among premature and neonates is Necrotizing Enterocolitis. There have been reports of mortality rates between 15% and 30%. Survivors are more likely to experience poor long-term growth and neurological damage, and surgical therapy is frequently required. Despite preventive measures like the use of donor milk, breastfeeding, prenatal glucocorticoid medication, and probiotic supplementation, Necrotizing Enterocolitis is still somewhat frequent in most neonatal intensive care units. Aim: To study the Risk Factors for Necrotizing Enterocolitis among Palestinian Premature and Neonates. Methodology: A qualitative, descriptive, retrospective study design was conducted at tertiary care hospitals (Governmental & Non-governmental) on the West Bank which contain neonatal intensive care units and treat necrotizing enterocolitis. The study population was all premature and neonates diagnosed with necrotizing enterocolitis who met the inclusion criteria. A convincing sample was composed of (191) premature neonates who participated in the study. Result: The classification of births regarding gestational age, according to WHO standards, shows that in our study: 28.3% were extreme preterm births (24 to 27 weeks and 6 days), 48.7% were very preterm (28 to 31 weeks and 6 days), 15.7% were moderate to late preterm (32 to 36 weeks and 6 days), and 7.3% were term births (37 weeks or more). The average v birth weight was 1471 grams (with a standard deviation of 711 grams), and the average maternal age was 27 years (with a standard deviation of 5 years). Regarding the severity of necrotizing enterocolitis based on the modified Bell's Classification: 5.3% were stage IA (suspected), 13.7% were stage IB (suspected), 21.1% were stage IIA (definite, mildly ill), 17.4% were stage IIB (definite, moderately ill), 20.5% were stage IIIA (advanced, severely ill with bowel intact), and 22.1% were stage IIIB (advanced, severely ill with bowel perforation). Additionally, the maternal and sociodemographic data revealed varied rates of conditions such as hypertension, smoking, infections, and socio-economic status, offering a thorough overview of the health and socio-demographic characteristics of the sample. Conclusion: While the average birth weight and maternal age were typical, the frequent occurrence of severe necrotizing enterocolitis highlights the serious health challenges these premature neonates face. Additionally, the varied maternal and sociodemographic factors, such as hypertension, smoking, infections, and socio-economic status, reveal the complex influences on both maternal and infant health.