title: Necrotizing enterocolitis in the first 24 hours of life.
abstract: Necrotizing enterocolitis (NEC) is commonly thought of as occurring in the sick premature infant, usually in the first one to two weeks of life. A review of NEC at the Children's Hospital of Denver over a 5-year period, found that 13 of 79 infants (16.1%) had onset of NEC during the first day of life. These infants were larger (mean birth weight 2,624 +/- 849 g), more mature (mean gestational age 37.9 +/- 2.5 weeks), and less asphyxiated as judged by Apgar scores (mean five-minute score 8.15 +/- 1.07) than infants with onset of NEC after the first day of life (mean birth weight 1,519 +/- 586 g, mean gestational age 32.0 +/- 3.5 weeks, P less than .001, and mean five-minute Apgar score 6.81 +/- 1.84, P less than .05). Despite their large size and degree of maturity, eight of these infants (62%) showed signs of respiratory distress; four (31%) were polycythemic; four (31%) had either a partial or double-volume exchange transfusion performed; and 11 (85%) were fed prior to developing NEC. Presenting signs of disease, occurrence of sepsis (31%), requirement for surgical intervention (62%), and mortality (30%) were similar for the two groups of infants. It is suggested that term and near-term infants who have significant illness after delivery be treated more like their premature counterparts with cautious introduction of feedings after an adequate period of stabilization.
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D002404:Catheterization; D004761:Enterocolitis, Pseudomembranous / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D005078:Exchange Transfusion, Whole Blood; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011086:Polycythemia / Q000150:complications; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D013997:Time Factors; D014469:Umbilical Arteries; D014471:Umbilical Veins