National prospective surveillance study of necrotizing enterocolitis in neonatal intensive care units

J Pediatr Surg. 2010 Jul;45(7):1391-7. doi: 10.1016/j.jpedsurg.2009.12.002.


Purpose: There is scant epidemiological data on necrotizing enterocolitis (NEC), so we conducted a national study to characterize prevalence, surgical management, and mortality.

Methods: A prospective cross-sectional survey was performed in the United Kingdom requesting data from 158 level 2 and 3 neonatal intensive care units (NICUs) during 2 winter and 2 summer months in 2005 to 2006; 51% of questionnaires were returned. Results are given as percentage with 95% confidence intervals.

Results: (1) Period prevalence: 211 infants were diagnosed with NEC (45% Bell's stage I, 21% stage II, and 33% stage III) from a total of 10,946 NICU admissions, with a period prevalence of 2% (1.7-2.2). In infants less than 1000 g birth weight, the prevalence was 14% (12-16), and in less than 26 weeks of gestation, 14% (11-17). Prevalence decreased significantly with increasing birth weight (P < .0001) and increasing gestation (P < .0001). (2) SURGERY: 66 infants received surgical procedures; peritoneal drain in 13 (followed by laparotomy in 8) and in 53, laparotomy alone. (3) Mortality: 27 infants died with NEC of a total 283 deaths, thus, accounting for 9.5% of NICU mortality. Eight (30%) infants with NEC died without surgery.

Conclusions: Prevalence of NEC in the United Kingdom is high and comparable to published series in other countries from the 1990s. There may be a hidden mortality in patients who do not receive surgery.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Enterocolitis, Necrotizing / epidemiology*
  • Enterocolitis, Necrotizing / mortality
  • Enterocolitis, Necrotizing / surgery
  • Enterocolitis, Necrotizing / therapy
  • Hospital Mortality
  • Humans
  • Infant, Extremely Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal
  • Population Surveillance
  • Prevalence
  • Prospective Studies
  • United Kingdom / epidemiology