Time to occurrence of necrotizing enterocolitis and its predictors among low birth weight neonates admitted at neonatal intensive care unit of felege hiwot compressive specialized hospital BahirDar, Ethiopia, 2021: A retrospective follow-up study

Abstract

Background Globally, the incidence of necrotizing enterocolitis (NEC) varies between 6 and 15% of all neonates admitted to the neonatal intensive care unit (NICU). Though necrotizing enterocolitis is a multifactorial and life-threatening disease, low birth prematurity is the single cause. Therefore, determining the time to presentation and its predictors of necrotizing enterocolitis were the main goals of this investigation. Materials and methods An institution-based retrospective follow-up study was conducted among 747 low birth weight (LBW) neonates admitted to the neonatal intensive care unit of Felege Hiwot comprehensive specialized Hospital from 1 January 2017 to 30 December 2019. The sample size was calculated by using the STATA package. Data were entered into Epi data version 3.1 and exported to STATA version 14 for analysis. The log-rank test and the Kaplan–Meier estimator were used to display the survival probability and differences between groups. At a significance threshold of 5%, Cox proportional hazard regression was performed to determine the net independent predictors of necrotizing enterocolitis. Result The overall incidence rate was 0.86 per 1,000 person-days (95% CI : 0.67, 1.14) with a 6.8% (95% i: 5.2, 8.9) proportion of necrotizing enterocolitis among low birth weight neonates. Preeclampsia [adjusted hazard ratio ( AHR );1.92 (95% CI: 1.03–3.58)], premature rapture of membrane [ AHR ; 2.36 (95%, CI : 1.19–4.69)], perinatal asphyxia [ AHR ; 4.05 (95%, CI : 2.04–8.60)], gestational age between 28 and 32 weeks [ AHR ; 3.59 (95% CI : 1.01–8.83)], and birth weigh less than 1,000 g [ AHR ; 5.45 (95% CI : 3.84–9.12) were the independent predictors of necrotizing enterocolitis. Conclusion Within the first 1–7 days of a newborn’s life, necrotizing enterocolitis was most common. It was discovered that preeclampsia, premature rupture of membrane, perinatal asphyxia, gestational age of 28–32 weeks, and birth weight less than 1,000 g were predictors of its occurrence.