title: Necrotizing enterocolitis in small-for-gestational-age neonates: a matched case-control study.
abstract: BACKGROUND
  Small for gestational age (SGA) neonates are at increased risk of mortality and morbidity, including necrotizing enterocolitis (NEC), but detailed information on the incidence and risk factors of NEC in SGA neonates is lacking.
  
  
  OBJECTIVE
  This study aims to estimate the incidence of NEC in a large cohort of SGA neonates, compared to appropriate for gestational age (AGA) neonates.
  
  
  METHODS
  We included all SGA neonates without congenital malformations admitted to our neonatal nursery between 2004 and 2013. Neonates in the SGA group were matched for gestational age with a control group of AGA neonates admitted during the same study period. We recorded the occurrence of NEC and studied the association with SGA and other potential risk factors.
  
  
  RESULTS
  A total of 475 SGA neonates were matched for gestational age at birth to 475 control AGA neonates. The incidence of NEC in the SGA group was 3.2% (15/475) versus 1.3% (6/475) in the AGA group (OR 2.55, 95% CI 0.98-6.63, p = 0.047). The incidence of NEC in the subgroups with mild, moderate and severe SGA was 2.3% (5/215), 4.7% (5/1.07) and 3.2% (5/153), respectively (p = 0.531).
  
  
  CONCLUSIONS
  The risk of development of NEC is more than twofold increased in SGA neonates compared to AGA neonates. We found no association between the severity of SGA and NEC.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Isabelle M C
authors.initials: IM
authors.lastname: Ree
authors.forename: Vivianne E H J
authors.initials: VE
authors.lastname: Smits-Wintjens
authors.forename: Esther G J
authors.initials: EG
authors.lastname: Rijntjes-Jacobs
authors.forename: Iris C M
authors.initials: IC
authors.lastname: Pelsma
authors.forename: Sylke J
authors.initials: SJ
authors.lastname: Steggerda
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
authors.forename: Enrico
authors.initials: E
authors.lastname: Lopriore
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index