Ağır İntrauterin Gelişme Geriliği ve Uzun Süreli Antibiyotik Kullanımı Prematürelerde Nekrotizan Enterokolit Gelişimini Önlediği Bilinen Beslenme Stratejilerinin Koruyuculuğunu Azaltabilir

Amaç: Bu çalışmanın amacı nekrotizan enterokolit (NEK) olan ve olmayan premature yenidoğanları karşılaştırarak, NEK gelişimi açısından ünitemizdeki risk faktörlerini gözden geçirmekti. Yöntem ve Gereç: Gestasyon yaşı ≤ 35 hafta ve doğum tartısı ≤ 1500 gram olan 94 premature yenidoğan çalışmaya dahil edildi. Çalışmaya katılan yenidoğanların karakteristik özellikleri karşılaştırıldı. Bulgular: NEK, çalışmaya katılan hastaların %15.9’da görüldü. NEK olmayan 79 ve Evre 2 ve 3 NEK olan 15 hasta karşılaştırıldı. İntrauterin gelişme geriliği (IUGR) ile geç sepsis ve dolayısıyla geniş spektrumlu antibiyotik kullanımı NEK grubunda anlamlı olarak yüksek bulundu. Tanı sırasında NEK olan hastaların %93’ü anne sütü veya güçlendirilmiş anne sütü ile beslenirken formül süt ile beslenen yoktu ve %7’si hiç beslenmemişti. Evre 3 NEK olan hastaların tümüne cerrahi tedavi uygulandı ve mortalite %33 idi. Sonuç:NEK sıklığının yüksek olduğu ünitelerde anne sütüyle beslenmeye ek stratejilerin geliştirilmesi gereklidir.

Severe IUGR and Long Duration of Antibiotic Treatment may Overcome the Benefits of Appropriate Feeeding Strategies to Prevent Necrotising Enterocolitis

Aim: To compare the characteristic features of premature neonates whodeveloped necrotizing enterocolitis (NEC) or not and review the risks for NECin our neonatal intensive care unit.Materials and Method: Ninety four premature neonates with gestational age≤ 35 weeks and/or birth weight ≤1500 g were included into the study.Characteristic features of the study neonates were compared.Results: NEC occurred in 15.9% of the study population. Seventy nineneonates who did not develop NEC and 15 neonates who developed stage IIand III NEC were compared. The rate of intrauterine growth restriction (IUGR),late onset sepsis and therefore broad-spectrum antibiotic usage weresignificantly higher in the group who developed NEC. At the time of diagnosis93 % of NEC positive patients were on full feeds either with breast milk onlyor breast milk + fortifier, none of them were formula fed, 7 % of the cases werenever fed. Surgery was performed in all stage III NEC patients and overallmortality rate was 33%.Conclusion: Our findings suggest that together with exclusive breast feedingregimen, other strategies to prevent NEC should be implemented in this highrisk preterm neonates.

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