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Necrotizing enterocolitis rate increased in Sweden
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After an early decrease, the rate of necrotizing enterocolitis has increased in Sweden since the late 1980s, according to recent study findings published in Pediatrics.
“Our results, in contrast to others, reveal that concerns about a possible rise in incidence rates of [necrotizing enterocolitis] are justified, but the mechanisms behind this observation seem to be complex, with improved survival of the most premature as one of many contributing factors,” researchers wrote.
The study included all children with a diagnosis of necrotizing enterocolitis from a Swedish birth cohort from 1987 to 2009. Researchers evaluated necrotizing enterocolitis incidence, early mortality and seasonality, along with descriptive statistics, Poisson regression and auto regression.
Researchers found an overall incidence of necrotizing enterocolitis of 3.4 in 10,000 live births that was higher in boys (incidence rate ratio [IRR]=1.22; 95% CI, 1.06-1.40). There was a peak in November and a low in May. There was an average increase of 5% per year during the study period.
They also found a steady increase that followed an initial decrease in most of the subgroups, except the most immature. However, 7-day mortality decreased in all subgroups during the study period (IRR=0.96; 95% CI, 0.95-0.96). It was especially obvious in the most premature and low birth weight infants.
“Because early survival of the most vulnerable infants continues to improve, the incidence rates of [necrotizing enterocolitis] most probably will continue to rise,” researchers wrote. “Differentiated epidemiologic knowledge and improved understanding of the pathogenesis and pathophysiology of [necrotizing enterocolitis] are needed to achieve effective prevention strategies and early detection of individuals at risk.”
Disclosures: The study was supported by the County Council of Ostergotland, Futurum, the Academy of Health Care, Jonkoping County Council, Jonkoping, Sweden, and the Medical Research Council of Southeast Sweden.
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