Abstract

Factors Contributing to Necrotizing Enter Colitis among Neonates in the Neonatal Intensive Care Unit of Public Hospital in Central Ethiopia: An Unmatched Case-Control Study

Author(s): Arega Abebe Lonsako

Background: Necrotizing Enterocolitis (NEC) is a severe condition in newborns that causes intestinal inflammation, infection, and necrosis, with lasting impacts on survivors’ health and quality of life. It remains a leading cause of neonatal morbidity and mortality, especially in developing countries. In Ethiopia, limited research exists on the factors contributing to NEC. This study aimed to identify the factors associated with NEC among neonates admitted to the neonatal intensive care unit of a public hospital in Central Ethiopia.

Methods: A facility-based unmatched case-control study was conducted from August 1 to 30, 2024, among neonates admitted to the NICU of public hospitals in Central Ethiopia. Cases were neonates diagnosed with Necrotizing Enterocolitis (NEC), while controls were those admitted without NEC. Data were collected via interviews and record reviews. Binary and multivariable logistic regression analyses were performed, with Adjusted Odds Ratios (AOR) and 95% Confidence Intervals (CI) reported. Associations with a p-value<0.05 were considered statistically significant.

Result: This study included 133 cases and 397 controls. Factors significantly associated with necrotizing enterocolitis in neonates were chorioamnionitis (AOR 4.04; 95% CI: 2.33, 6.97), formula milk use (AOR 2.47; 95% CI: 1.50, 4.06), prolonged hospital stay (AOR 2.06; 95% CI: 1.27, 3.33), continuous positive airway pressure support (AOR 2.29; 95% CI: 1.36, 3.87), and premature rupture of membranes (AOR 2.52; 95% CI: 1.55, 4.12).

Conclusion: Chorioamnionitis, extended hospital stay, the use of continuous positive airway pressure support, and premature rupture of membranes were positively significantly associated with the development of necrotizing enterocolitis in newborns. Special attention should be given to the prevention, early detection, and treatment of necrotizing enterocolitis.