From: Global incidence of Necrotizing Enterocolitis: a systematic review and Meta-analysis
Author/year | data base studied | Inclusion criteria | Exclusion criteria | Population at risk reported | NEC case definition | Comment on VLBW | Incidence (cumulative) |
---|---|---|---|---|---|---|---|
Stoll et al. 2010 [18] | NICHD | VLBW infants born in NRN centers GA 22–28 wks. | Congenital anomalies | preterm infants among a VLBW pool | clinically | exclusively VLBW infants | 11% |
Llanos et al. 2002 [3] | Finger Lakes regional center | all live births in an area of 6 counties. Data obtained from a state-wide registry. | not clear | all newborns in the regional center were accounted for but specific report on NEC stage II and above among the VLBW infants is extracted | NEC stage II and above | population based study but reported specific parameters on VLBW | 3.29% |
Luig et al. 2005 [4] | New South Wales – state-wide data base. NICUS Neonatal Intensive Care Unit Study | population based study - all preterm infant s between 24 and 28 wks. | not clear | all preterm infants 24–28 weeks of gestation | Clinical definition as confirmed NEC on a set of criteria similar to Bell’s criteria | the mean birth weight and SD of the three epochs were 959 (240), 946 (204), and 935 (240) | 7.67% |
Holman et al. 2006 [19] | data from discharge registry (the kid’s Inpatient Database) compiled data from 27 states, 2700 hospitals accounting for 10% uncomplicated births from these hospitals | the data is a comprehensive cohort of 10% of all live births in the specified hospitals. | NE after 1 month of age | VLBW infants | ICD 9 -CM code NEC 777.5 | Specific report NEC and VLBW infants is presented exclusively VLBW infants | 4.34% |
Youn 2015 [16] | Korean Neonatal Network. Admissions into 55 participating neonatal intensive care unites | all live births or admissions within 28 days. VLBW infants. Data collected | 52 were diagnosed with NEC II and Spontaneous bowel perforation and were excluded | VLBW infants | bell’s stage II and above | exclusively VLBW infants | 6.41% |
Qian et al. 2017 | 95 major referral centers in 29 provinces. Representative of NICU care in the areas | all LBW infants were included. | not specified | the study reports specific parameters of VLBW infants | bell’s stage II and above | reports on VLBW infants are extracted from the publications | 2.53% |
Ahle et al. 2013 [12] | Swedish National Board of Health and Welfare, the National Patient Register, the Swedish Medical Birth Register and the National Cause of Death Register | all newborns between 1987 and 2009 | incomplete identity number | VLBW infants | ICD 9 or ICD 10 code 777F or P77 | reported all birth weights. Exact parameters of each weights group are available too | 2.68% |
Wojkowska-Mach et al. 2014 | Polish Neonatal Surveillance Network | all VLBW infants born in PNSS | missing records | VLBW infants | NEC defined according to Gastmeier’s (clinical) | exclusively VLBW | 8.68% |
Boo et al. 2012 [14] | Malaysian National Neonatal Registry includes NICUs in Malaysia | All VLBW infants in the MNNR. | excluded infants less than 501 g | VLBW infants | bell’s stage II and above | exclusively VLBW infants | 6.20% |
Wong et al. 2013 | Population based study: New South Wales and Australian Capital Territory NICUs included in the NICUS | Low birth weight infants | congenital malformation, syndromes with neurodevelopmental disorders, death in the labor room | low birth weights infants | Bell’s staging criteria | the population was of low birth weights (mean birth weight in two groups was 895 and 917 g. | 7.81% |
Fanaroff 2003 [20] | NICHD. Retrospective data analysis was performed to compare three epochs. | Registry data | not specified | VLBW infants | not clear | VLBW infants | 6.23% |
Chedid et al. 2008 | Single large Neonatal tertiary referral center | all admission to a single tertiary center in Alain between 2004 and 2006 | life threatening malformation, died in labor room, less than 500 g | VLBW infants (exclude less than 500 g | not clear, pneumatosis intestinal or perforation was used a confirmation | all are VLBW | 5.78% |
Agrawel et al. 2015 | data from single largest tertiary hospital in Singapore. Viability threshold less than 25 wks. Gestation | Neonates from High risk VLBW data base with GA < 29 wks. | still birth and miscarriage, less than 23 weeks of gestation | VLBW and pre-term | bell’s stage II and above | exclusively VLBW infants | 6.98% |
Patole et al. 2016 [21] | single center experience. Comprehensive retrospective cohort comparing a before and after intervention | all neonates less than 34 weeks of gestation within a 2-year period before and after intervention | neonates involved in a clinical trial for the same purpose | the study reported all neonates less than 34 wks. But data on < 28 weeks and epoch 1 were extracted | bell’s stage II and above | the birth weight of the preterm babies was not specifically reported | 6.40% |
Verstreate et al. 2016 | Retrospective cohort study from a single e center using a local audit data base | All neonates in the hospital system | neonates with culture samples that had probably contamination | data on VLBW was extracted only | clinical definition | the data extracted represents exclusively VLBW infants | 16.23% |
Harkin et al. 2017 | Finish Medical Birth Register (preterm < 32 wks.) 22–31. all VLGA 4143 | all born less than 32 weeks of gestation | congenital malformations sever chromosomal defects or death before 7 days od life | less than 28 weeks of gestation | clinical criteria | 50% less than 1000 g in the entire populations. But weight of the < 28 weeks of gestation was not specified | 6.58% |
Andersen et al. 2018 | birth cohort of the California Office Statewide Health and Development (OSHPD) | all live births with GA 22–36 | chromosomal abnormalities | GA less than 28 weeks | ICD-9 | no clear specification of the birth weight of the preterm subpopulation | 9.10% |
Suciu et al. 2017 [22] | From three Romanian hospitals (tertiary centers) data from two different periods 2007–2010 and 2011–2014 | all preterm babies less than 28 weeks of gestation | chromosomal abnormalities and birth defects or missing data | preterm babies less than 28 weeks of gestation | bell’s stage II and above | the mean birth and SD of the two epochs were 809 +/−  211 and 958 +/−  149 | 17.08% |
Patel et al. 2016 | Prospective 0bservational multicenter birth cohort study evaluating VLBW infants from multiple Level III neonatal centers for exposure blood transfusion (a risk of NEC) | VLBW infants | not specified | VLBW infants | bell’s stage II and above. Cumulative incidence at 8 weeks | exclusively VLBW infants | 7.34% |
Bajwa et al. 2011 [23] | Swiss Neonatal Network. Double verification by the Swiss Society of Neonatology. | The data set includes all infants < 32 weeks of gestation and > 23 wks. | infants who died in labor room | preterm less than 28 weeks of gestation | clinical definition | no comment on the birth weight of the subpopulation less than 28 weeks of gestation | 4.95% |
Narang et al. 1993 [24] | Single Neonatal Intensive Care Unit | All live births during the period January 1986 to September 1990 | Not reported | VLBW infants and pretenn infants of gestational age less than 32 weeks | modified Bell’s criteria | Majority are VLBW infants | 1.5% |
Lodha 2019 [25] | Tertiary neonatal intensive care units participating in the Canadian Neonatal Network | born at 22 to 28 weeks’ gestational age | birth outside a tertiary-level NICU, moribund at birth, designated as needing palliative care before delivery, had major congenital anomalies, or lacked cord clamping information | 22 to 28 weeks’ gestational age | According to the modified Bell criteria, and NEC stage 2 or higher was classified as medical or surgical. | No estimate of the percentage of VLBW infants | 9% |
Boghossian 2018 [26] | Vermont Oxford Network center | Inborn, singleton infants without congenital malformations | Infants with unknown sex and missing or implausible birth weight | Infants of gestational ages 22 to 29 weeks | diagnosed at surgery or postmortem or required at least 1 clinical sign (eg, bilious gastric aspirate, abdominal distension, or occult blood in stool) and at least 1 radiographic finding (eg, pneumatosis intestinalis, hepatobiliary gas, or pneumoperitoneum). | the mean birth weight and SD of the each weeks reported. | 9% |
Persson 2018 [27] | 7 national networks in high-income countries that are part of the International Neonatal Network for Evaluating Outcomes in Neonates | All singleton infants born alive in high-income countries who were very preterm (24-31 weeks’ gestation) and with a birth weight of less than 1500 g | Multiple pregnancies and major congenital malformations | Very Preterm and Very Low-Birth-Weight Infants | Necrotizing enterocolitis was analyzed in a subgroup of the cohort because data from the UKNC were not available for stage 2 or 3 NEC | Very Preterm and Very Low-Birth-Weight Infants | 3% |
Suzuki 2018 [28] | Neonatal Research Network | Extremly preterm infants born between 2008 and 2012 | Infants who died within 6 days, infants with congenital anomalies, whose sex was undetermined, or whose records were missing data | extremely preterm infants | NEC was defined as stage II/III cases, according to the classifications of Bell | All are VLBW with extremly preterm | 4% |
Boghossian 2018 [29] | 852 US centers participating in the Vermont Oxford Network | Infants born between 154 days (22 weeks and 0 days) and 209 days (29 weeks and 6 days) of gestation | Multiples and infants born with congenital malformations | Large for Gestational Age Infants | NEC was diagnosed at surgery or postmortem or required at least 1 clinical sign (eg, bilious gastric aspirate, abdominal distension, occult blood in stool) and at least 1 radiographic finding (eg, pneumatosis intestinalis, hepatobiliary gas, or pneumoperitoneum) | Mean and SD birth weights reported | 7% |
Beltempo 2018 | Canadian Neonatal Network | Infants born from 22 to 28 weeks’ GA and admitted to 30 Level 3 neonatal intensive care units (NICUs) | Infants moribund on admission or where palliative care was provided at birth due to imminent mortality, infants with major congenital anomalies, and infants with missing SNAP-II | Extremely preterm infants | NEC is defined as stage ≥2 according to Bell’s criteria | Mean and SD birth weights of both cohort is reported | 8% |