International Scholarly Research Network ISRN
Gastroenterology Volume 2012, Article ID 562594, 7 pages
doi:10.5402/2012/562594
Review Article Necrotizing Enterocolitis in Very Low Birth Weight Infants: A
Systemic Review
Bhoomika K. Patel and Jigna S. Shah
Department of Clinical Pharmacy, Shri Sarvajanik Pharmacy College, Near Arvind
Baug, Gujarat, Mehsana 384001, India Correspondence should be addressed to
Jigna S. Shah, jignashah74@yahoo.com Received 18 April 2012; Accepted 19 June
2012 Academic Editors: C.-Y. Chen and C. Sperti Copyright © 2012
B. K. Patel and J. S. Shah. This is an open access article distributed
under the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is
properly cited. Necrotizing enterocolitis (NEC) is the most common serious
gastrointestinal disorder affecting very preterm or very low birth weight
infants. The risk is inversely proportional to gestational age and weight at
birth. Fetal growth restriction and compromise may be additional speciï¬c risk factors. Despite extensive research and animal
studiesetiopathogenesis, preventive strategies and management options remain
controversial. The present paper reviews the literature for recent advances and
newer insights for changing epidemiological trends, pathogenesis, role of
inflammatory cytokines, and various preventive and management strategies.
1. Introduction
Necrotizing enterocolitis (NEC) is a devastating
condition of the neonatal period characterized by bowel necrosis and
multisystem organ failure. It is well known that NEC is associated with
prematurity and particularly with extremely low birth weight [1–3]. Necrotizing
enterocolitis is rare in term infants [4], in whom it is usually associated
with congenital anomalies, sepsis, or hypotension [5]. The morbidity and
mortality are high, and optimal strategies for treatment remain elusive,
despite decades of research.
Population studies from India
on this condition are not widely publicized. In one such report the incidence
of NEC in babies less than 32 weeks gestation was 5.2% [6]. Mortality rates
vary across centres and range from 10 to 40% depending on gestational age of
the baby [7–10].
3. Risk Factors
(1) Prematurity (
