Risk factors associated with the development of necrotizing enterocolitis in preterm infants on an exclusive human milk diet: a single-center case-control study.

OBJECTIVE

Identify early neonatal and maternal risk factors for development of necrotizing enterocolitis (NEC) in preterm infants receiving an exclusive human milk diet (EHMD).

STUDY

DESIGN

Preterm infants who developed NEC stage ≥2 while receiving an EHMD were compared to matched controls who did not develop NEC on the same diet. Predictors of NEC were selected for multiple-predictor logistic regression analysis based on literature or significance in single-predictor models.

RESULTS

A total of 27 cases and 98 controls (mean GA = 27 weeks) were included. Groups did not differ significantly on baseline characteristics. Maternal urinary tract infection, maternal neutrophil-to-lymphocyte ratio before delivery, and vasopressor use during the first week significantly predicted NEC.

CONCLUSION

Despite the use of EHMD, NEC remains a concern, underlining its multifactorial nature. Results highlight the potential role of maternal inflammation and early neonatal hemodynamic instability in NEC development. Findings could inform future research aimed at identifying high-risk infants.