A review of necrotising enterocolitis in very low birth weight babies in a tertiary hospital in Johannesburg: a retrospective study

Motsisi, Sandra
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Background: Necrotisingenterocolitis (NEC) is the most common gastrointestinal complication in premature infants. There are risk factors and modifying factors that have been identified and studied over the years, but not many studies have been done in middle-income countries. Objectives: The objectives of this study were to describe the maternal, obstetric and neonatal characteristics in very low birth weight (VLBW) babies with NEC at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), South Africa. The survival to hospital discharge in VLBW babies with NEC was determined. Methods: A retrospective cross-sectional observational study of VLBW babies admitted to a tertiary neonatal unit between January 2013 and December 2017. The population comprised babies <1500g and <37 weeks gestation. Maternal and neonatal risk factors of NEC were compared in infants with and without NEC. Results: In this study, 173 out of 2111 (8%) babies were diagnosed with NEC. Maternal age and HIV increase the risk of NEC. Neonatal factors, including late-onset sepsis, respiratory support after initial resuscitation, administration of surfactant and blood transfusion were associated with an increased risk of NEC. Babies diagnosed with NEC had an increased risk of mortality. Conclusion: Risk factors for NEC in our population are similar to other countries, with some variations such as HIV. Even though some prevention measures have been implemented, the mortality rate remains high.
A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine