A case-control study was performed for the period November 1, 1997, through May 1, 1999. All cases of proven
necrotizing enterocolitis were ascertained, and four controls for each case were randomly identified from all Special Care Nursery admissions before 37 weeks' gestation without
necrotizing enterocolitis during that same period.
RESULTS: During the 18-month period there were 24 cases of
necrotizing enterocolitis out of 10,200 deliveries. Infants with
necrotizing enterocolitis were more preterm (29.7 +/- 3.9 compared with 32.7 +/- 6.0 weeks; P =.03) and had lower
birth weights (1453 +/- 777 compared with 1820 +/- 678 g; P =.02) compared with controls (n = 96).
Respiratory distress syndrome (RDS) and
sepsis were both significantly associated with an increased risk of
necrotizing enterocolitis: 16 of 24 cases compared with 40 of 96 controls had RDS (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.0, 8.3) and 14 of 24 cases compared with 11 of 96 controls were septic (OR 10.8, 3.4, 95% CI 34.2).
Indomethacin as a single agent was not associated with
necrotizing enterocolitis (OR 1.0, 95% CI 0.2, 4.8). Using a logistic regression model,
necrotizing enterocolitis was strongly associated with
sepsis (adjusted OR 8.5, 95% CI 2.2, 32.5). When
sepsis was removed from the model, double-
agent tocolytic therapy was significantly associated with
necrotizing enterocolitis (adjusted OR 6.9, 95% CI 1.1, 43.6).
CONCLUSION: