Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency and remains a major cause of mortality for very-low-birth-weight infants (VLBWI) requiring surgery. To date, there have been no large-scale studies evaluating the incidence, associated clinical factors and outcomes of NEC for VLBWI in Korea. The 2,326 VLBWI of a total 2,386 Korean Neonatal Network (KNN) cohort born with a birth weight below 1,500 g between January 2013 to June 2014 were included in this analysis. The overall incidence of NEC (stage > or = 2) among VLBWI in Korea was 6.8%; 149 infants had NEC stage > or = 2 and 2,177 infants did not have NEC. Surgery was performed for 77 (53%) of the infants in the NEC group. NEC was related to lower gestational age (GA) and birth weight (P < 0.001). Multivariate logistic regression analysis demonstrated that NEC was consistently related to hypotension within one week after birth (OR 2.0, 95% CI 1.0-3.9). With respect to outcome, the NEC group had longer times to reach 100 mL/kg/day feeding (P < 0.001), longer TPN duration (P < 0.001) and hospitalization (P = 0.031) and higher PVL (P < 0.001) and mortality rate (P < 0.001). When the medical and surgical NEC groups were compared, GA was significantly lower and PDA was more found in the surgical NEC group. The overall incidence of NEC in Korea is similar to that of other multicenter studies. In addition to GA and birth weight, hypotension within a week of life is significantly related to NEC.
Birth Weight ; Databases, Factual ; Enterocolitis, Necrotizing/*epidemiology/mortality ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; Infant, Premature ; *Infant, Very Low Birth Weight ; Logistic Models ; Male ; Odds Ratio ; Republic of Korea/epidemiology ; Risk Factors

PURPOSE: This study aimed to identify the morbidity in very low birth weight infants (VLBWI) and low birth weight infants (LBWI) in Korea and compare these data with similar data from Japan and the USA. METHODS: The analysis of morbidity in VLBWI in Korea was based on a 2012 survey of morbidity in LBWI in Korea. These findings were compared with the morbidity of VLBWI and LBWI in Japan and the USA. RESULTS: Morbidities in LBWI included jaundice (58.5%), respiratory distress syndrome (RDS; 37.0%), apnea (22.2%), patent ductus arteriosus (PDA; 22.0%), and small for gestational age (SGA; 19.2%). The research findings concerning LBWI morbidity found, high prevalence rates for neonatal jaundice, RDS, PDA, SGA, apnea, and sepsis. Compared with VLBWI morbidity of Japan and the USA, intraventricular hemorrhage, RDS, PDA, and sepsis were more prevalent in Korea, whereas bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity occurred at similar frequencies in all 3 countries. CONCLUSION: This study provides a recent nationwide summary of disease-specific morbidity in VLBWI and LBWI in Korea. Based on this study, future research and surveys are needed to identify the disease-specific mortality and survival rates in the field of neonatal intensive care.
Apnea ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Epidemiology ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Japan* ; Jaundice ; Jaundice, Neonatal ; Korea ; Mortality ; Prevalence ; Retinopathy of Prematurity ; Sepsis ; Survival Rate