Predictive Factors for Surgery in Preterm Neonates with Necrotizing Enterocolitis: A Retrospective Cohort Study

Abstract

Objectives: Necrotizing enterocolitis (NEC) is a severe neonatal condition. This study aimed to assess predictive factors for surgical treatment in preterm neonates with NEC in a Tunisian center. Methods: We present a retrospective study including all neonates treated for NEC between January 01, 2010 and March 31, 2022. Results: Within the study period, 102 patients were included, with an overall survival of 47%. Most of our patients were male (64.7%), with low birth weight or less (100%), 5-min Apgar score ≥8 (79.4%), and Bell’s stage II (66.7%). Multivariate logistic analyses demonstrated that gestational age <30 weeks (p=0.002, odds ratio [OR]=4.544), birth weight <1000 g (p=0.001, OR=5.750), NEC onset <7 days (p<0.001, OR=5.667), not being breastfed (p=0.019, OR=3.026), and C-reactive protein level >20 mg/L (p=0.020, OR=2.942) were associated with the need for surgical treatment in neonates with NEC. Conclusion: Our findings would be helpful in refining treatment modalities for better disease outcomes.