Unchanged incidence of necrotising enterocolitis in a tertiary neonatal department.

INTRODUCTION At the Department of Neonatology at Rigshospitalet, Copenhagen, Denmark, decades of extensive use of mother's milk and human donor milk should theoretically limit the incidence of necrotising enterocolitis (NEC) among very low birth weight infants. The aim of this study was to determine our local incidence of NEC from 1996 to 2009. METHODS The data in departmental clinical database containing information about admissions in the 1996-2009 period was compared with data in the Danish Patient Registry. Inconsistencies were resolved by reviewing the clinical records. The population of interest was infants inborn at Rigshospitalet with an age of 0-1 days on admission. RESULTS A total of 8,893 infants were included in the study and 1,843 (20.7%) weighed less than 1,500 g at birth. NEC occurred in 111 of these (6.0%). The incidence ranged from 20.5% in the 500-599 g birth-weight group to 0.5% in the 1,200-1,299 g birth-weight group. There was no trend over time in the incidence of NEC (b = -0.02/year (95% confidence interval: -0.59; 0.55, p = 0.98) and no evidence of a higher frequency of NEC in certain months or certain seasons (p = 0.52 and p = 0.32). CONCLUSION Our incidence of NEC was close to average compared with incidences reported in international literature. There was no suggestion of an epidemic cause or that the incidence was decreasing. Considering the impact of NEC on the individual infant, it is important to keep searching for new ways to reduce the problem. FUNDING not relevant. TRIAL REGISTRATION The study was approved by the Danish Data Protection Agency.

[1]  G. Greisen,et al.  Age and weight at final discharge from an early discharge programme for stable but tube‐fed preterm infants , 2015, Acta paediatrica.

[2]  W. McGuire,et al.  Formula versus donor breast milk for feeding preterm or low birth weight infants. , 2014, The Cochrane database of systematic reviews.

[3]  R. Andersson,et al.  Epidemiology and Trends of Necrotizing Enterocolitis in Sweden: 1987–2009 , 2013, Pediatrics.

[4]  J. Moorman,et al.  Abnormal heart rate characteristics before clinical diagnosis of necrotizing enterocolitis , 2013 .

[5]  R. Mori,et al.  Comparison of Mortality and Morbidity of Very Low Birth Weight Infants Between Canada and Japan , 2012, Pediatrics.

[6]  S. Kouwenhoven,et al.  Intake of Own Mother’s Milk during the First Days of Life Is Associated with Decreased Morbidity and Mortality in Very Low Birth Weight Infants during the First 60 Days of Life , 2012, Neonatology.

[7]  Robert Christensen,et al.  Mapping the New World of Necrotizing Enterocolitis (NEC): Review and Opinion. , 2012, The e-journal of neonatology research.

[8]  L. Lehtonen,et al.  Incidence of necrotizing enterocolitis in very‐low‐birth‐weight infants related to the use of Lactobacillus GG , 2010, Acta paediatrica.

[9]  V. Sharma,et al.  Seasonal variation in the incidence of necrotizing enterocolitis , 2010, Pediatric Surgery International.

[10]  C. Weldon,et al.  Mortality of necrotizing enterocolitis expressed by birth weight categories. , 2009, Journal of pediatric surgery.

[11]  J. Padbury Epidemiology of necrotizing enterocolitis temporal clustering in two neonatology practices , 2009 .

[12]  L. Gagliardi,et al.  Necrotising Enterocolitis in Very Low Birth Weight Infants in Italy: Incidence and Non-nutritional Risk Factors , 2008, Journal of pediatric gastroenterology and nutrition.

[13]  E. Bullitt,et al.  Outbreak of Necrotizing Enterocolitis Caused by Norovirus in a Neonatal Intensive Care Unit , 2008, The Journal of Pediatrics.

[14]  R. Clark,et al.  Emerging trends in acquired neonatal intestinal disease: is it time to abandon Bell's criteria? , 2007, Journal of Perinatology.

[15]  R. Holman,et al.  Necrotising enterocolitis hospitalisations among neonates in the United States. , 2006, Paediatric and perinatal epidemiology.

[16]  Z. Qiu,et al.  Variations in Incidence of Necrotizing Enterocolitis in Canadian Neonatal Intensive Care Units , 2004, Journal of pediatric gastroenterology and nutrition.

[17]  F. Ebbesen,et al.  [Necrotizing enterocolitis. Occurrence in Western Denmark]. , 1995, Ugeskrift for laeger.

[18]  C R Bauer,et al.  Very-low-birth-weight outcomes of the National Institute of Child Health and Human Development Neonatal Network, November 1989 to October 1990. , 1995, American journal of obstetrics and gynecology.

[19]  Elizabeth A. Phillips,et al.  Necrotizing enterocolitis in very low birth weight infants: biodemographic and clinical correlates. National Institute of Child Health and Human Development Neonatal Research Network. , 1991, The Journal of pediatrics.

[20]  J D Horbar,et al.  Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Network. , 1991, Pediatrics.

[21]  M. J. Bell,et al.  Epidemiologic and bacteriologic evaluation of neonatal necrotizing enterocolitis. , 1979, Journal of pediatric surgery.