Case Reports in Surgery and Invasive Procedures

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (202) 780-3397

Short Communication - Case Reports in Surgery and Invasive Procedures (2023) Volume 7, Issue 5

Unmasking the risk factors of necrotizing enterocolitis

John Alberto*

Department of Surgical Endoscopy

*Corresponding Author:
John Alberto
Department of Surgical Endoscopy
University of Bologna

Received:29-Aug-2023, Manuscript No. AACRSIP-23-112559; Editor assigned:01-Sept-2023, PreQC No. AACRSIP-23-112559(PQ); Reviewed:15-Sept-2023, QC No. AACRSIP-23-112559; Revised:20-Sept-2023, Manuscript No. AACRSIP-23-112559(R); Published:27-Sept-2023, DOI:10.35841/aacrsip-7.5.165

Citation: Alberto J. Unmasking the risk factors of necrotizing enterocolitis. Case Rep Surg Invasive Proced. 2023;7(5):165

Visit for more related articles at Case Reports in Surgery and Invasive Procedures


Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disorder that primarily affects premature infants, particularly those born before 32 weeks of gestation. This condition is characterized by inflammation and tissue death in the intestines, which can lead to severe complications and even death in affected newborns. While the exact cause of NEC remains elusive, several risk factors have been identified that play a significant role in its development. In this article, we will uncover the risk factors associated with necrotizing enterocolitis, shedding light on the challenges faced by premature infants and their caregivers [1].

NEC often strikes with little warning and can progress rapidly, posing a grave threat to the health and well-being of premature infants. It is a condition that requires prompt recognition, intervention, and a multidisciplinary approach involving neonatologists, pediatric surgeons, nurses, and other healthcare professionals. Early identification of risk factors and close monitoring of at-risk infants are crucial steps in preventing NEC. Neonatal intensive care units (NICUs) employ strict protocols and guidelines to minimize these risk factors and reduce the incidence of NEC [2].

One of the most significant risk factors for NEC is prematurity. Babies born before 32 weeks of gestation or with a birth weight less than 1,500 grams (3.3 pounds) are particularly vulnerable to NEC. Premature infants have underdeveloped immune and digestive systems, making them more susceptible to the condition. Low birth weight is closely linked to prematurity and is an independent risk factor for NEC. Babies with low birth weight often lack the protective factors that a full-term infant has, including a fully developed gut and immune system [3].

The introduction of enteral feeding, specifically formula feeding, is associated with an increased risk of NEC in premature infants. The immature gut lining of preterm babies may struggle to digest and absorb nutrients from formula, making them more susceptible to intestinal inflammation. Infections, particularly those affecting the gastrointestinal tract, can trigger NEC. The presence of bacteria in the gut may contribute to inflammation and tissue damage. Healthcare-associated infections, especially in neonatal intensive care units (NICUs), are of particular concern. Episodes of low oxygen levels (hypoxia) and low blood pressure (hypotension) can diminish blood flow to the intestines. This reduced blood supply can lead to tissue ischemia (lack of oxygen), making the intestines vulnerable to NEC. Certain maternal factors, such as maternal illness during pregnancy, use of tobacco or illicit drugs, and maternal stress, may increase the risk of NEC in the newborn. The health and well-being of the mother can have a significant impact on the developing fetus [4].

Twins, triplets, and other multiple births are associated with an increased risk of NEC. The competition for nutrients and space in the womb can result in lower birth weights and prematurity, both of which are risk factors for NEC. The type of formula used for feeding premature infants may influence their susceptibility to NEC. Some studies suggest that certain preterm formula compositions may be associated with a lower risk of NEC compared to standard formula. Prolonged or inappropriate use of antibiotics in neonatal care can disrupt the balance of gut bacteria (microbiota) in premature infants, potentially increasing their vulnerability to NEC. The management and prevention of NEC continue to be areas of active research, with ongoing efforts to improve the care and outcomes of premature infants. Advances in neonatal care, early detection of NEC, and interventions to mitigate its risk factors offer hope for reducing the burden of this devastating condition and improving the chances of survival and long-term health for premature infants [5].



Necrotizing enterocolitis is a serious and often life-threatening condition that predominantly affects premature infants. While the exact cause of NEC remains unclear, a multitude of risk factors have been identified that contribute to its development. These risk factors encompass prematurity, low birth weight, enteral feeding, infections, episodes of hypoxia and hypotension, maternal factors, multiple births, formula type, and antibiotic use. Understanding these risk factors is crucial for healthcare professionals working in neonatal care units, as they can help identify infants at higher risk and implement preventive measures.


  1. Grandi C, Tapia JL, Cardoso VC. Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study. J Pediatr. 2015;91(3):234-41.

Indexed at, Google Scholar, Cross Ref

  1. Wong D, Abdel-Latif M, Kent A, et al. Antenatal steroid exposure and outcomes of very premature infants: a regional cohort study. Arch Dis Child Fetal Neonatal Ed. 2014;99(1):F12-20.

Indexed at, Google Scholar, Cross Ref

  1. Garcia-Munoz Rodrigo F, Galan Henriquez G, Figueras Aloy J, et al. Outcomes of very-low-birth-weight infants exposed to maternal clinical chorioamnionitis: a multicentre study. Neonatology. 2014;106(3):229-34.

Indexed at, Google Scholar, Cross Ref

  1. Cetinkaya M, Ozkan H, Koksal N. Maternal preeclampsia is associated with increased risk of necrotizing enterocolitis in preterm infants. Early Hum Dev. 2012;88(11):893-98.

Indexed at, Google Scholar, Cross Ref

  1. Tripepi G, Jager KJ, Dekker FW, et al. Testing for causality and prognosis: etiological and prognostic models. Kidney Int. 2008;74(12):1512-5.

Indexed at, Google Scholar, Cross Ref

Get the App