Mortality in Extremely Preterm Infants Are Strongly Associated with NEC: Data from Czech Neonatal Network

Introduction: Necrotizing enterocolitis (NEC) remains one of the leading causes of neonatal morbidity and mortality especially in extremely preterm infants. The aim of the study was to investigate the incidence of NEC and associated mortality in extremely preterm infants group from Czech Neonatal Network.

Materials and Methods: The Czech Neonatal Network database was consulted for records of preterm infants who were born at <28 weeks’ gestation from 2015 to 2017. Their data were analyzed, specifically for infant’s mortality and NEC rate. Infants were divided into four groups: less or equal than 24, 25, 26, and 27 weeks’ gestation. Statistical significances of the results were analyzed by the chi-square test.

Results: Overall, 712 infants who were born at <28 weeks’ gestation from 2015 to 2017 were identified from the dataset. The overall mortality rate was 21% during the study period. NEC rate was 12% and the mortality rate of infants with NEC was 51% compared with 16% in infants without NEC. The NEC rate was 18% in ≤24 weeks’, 17% in 25 weeks’, 9% in 26 weeks’, and 7% in 27 weeks’ gestation. Mortality rate were higher in infant with NEC in the groups of gestational age 25 weeks (71 vs. 14%, p < 0.001), 26 weeks (38 vs. 4%, p < 0.05), and 27 weeks (30 vs. 4%, p < 0.05) but not significantly differ in ≤24 weeks’ gestation.

Conclusion: In our study, the NEC rate of extremely preterm infant is associated with the gestational age. The mortality rate of these infants appears strongly associated with NEC at 25 to 27 weeks of gestation.

Keywords: NEC; extreme; mortality

Conflict of Interest: None declared.