How many infants are at risk for necrotizing enterocolitis (NEC)?

According to a 2008 review of the evidence, all newborn infants born preterm (before 37 weeks of pregnancy) or born with a low birth weight (less than 2,500 grams, or about 5.5 pounds) are at increased risk for NEC. The smaller the infant or the more premature the delivery, the greater the risk.1

The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) in 2019 listed NEC as one of the 10 leading causes of infant mortality.2 For recent data, please access the NCHS-compiled data on linked birth/infant death records in the United States, including underlying causes of death such as NEC, from CDC’s Wide-ranging ONline Data for Epidemiologic Research (WONDER) database.

The population most at risk for NEC is increasing because with technological advances in care the number of very low birth weight (VLBW) infants who survive continues to grow.1 The percentage of VLBW infants who develop NEC remains steady, however, at about 7%.1

Although NEC mostly occurs in preterm infants, it occasionally occurs in infants born at term. One study found that about 9% of all NEC cases that occurred in one children’s hospital over 30 years were in full-term infants.3 Full-term infants with NEC often have another serious illness or risk factor, such as congenital heart disease or restricted growth in the womb. NEC may also have a different disease process in full-term versus preterm infants.1

Citations

  1. Lin, P. W., Nasr, T. R., & Stoll, B. J. (2008). Necrotizing enterocolitis: Recent scientific advances in pathophysiology and prevention. Seminars in Perinatology, 32, 70–82.
  2. Kochanek, K. D., Xu, J. Q., & Arias, E. (2020). Mortality in the United States, 2019. NCHS Data Brief, No. 395. Retrieved August 27, 2024, from https://www.cdc.gov/nchs/products/databriefs/db395.htm
  3. Ostile, D. J., Spilde, T. L., St Peter, S. D., Sexton, N., Miller, K. A., Sharp, R. J. (2003). Necrotizing enterocolitis in full-term infants. Journal of Pediatric Surgery, 38(7), 1039–1042. 
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