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Prevention of necrotizing enterocolitis in premature infants - an updated review.
World J Clin Pediatr 2019; 8(2):23-32WJ

Abstract

Necrotizing enterocolitis (NEC) is among the most common and devastating diseases encountered in premature infants, yet the true etiology continues to be poorly understood despite decades of research. Recently, gut bacterial dysbiosis has been proposed as a risk factor for the development of NEC. Based on this theory, several best clinical practices designed to reduce the risk of NEC have been proposed and/or implemented. This review summarizes the results of recent clinical trials and meta-analyses that support some of the existing clinical practices for reducing the risk of NEC in premature infants. It is evident that human milk feeding can reduce the incidence of NEC. While most of the studies demonstrated that probiotic supplementation can significantly reduce the incidence of NEC in premature infants, there are still some concerns regarding the quality, safety, optimal dosage, and treatment duration of probiotic preparations. Antibiotic prophylaxis does not reduce the incidence of NEC, and prolonged initial empirical use of antibiotics might in fact increase the risk of NEC for high-risk premature infants. Lastly, standardized feeding protocols are strongly recommended, both for prevention of postnatal growth restriction and NEC.

Authors+Show Affiliations

Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31065543

Citation

Jin, Yu-Ting, et al. "Prevention of Necrotizing Enterocolitis in Premature Infants - an Updated Review." World Journal of Clinical Pediatrics, vol. 8, no. 2, 2019, pp. 23-32.
Jin YT, Duan Y, Deng XK, et al. Prevention of necrotizing enterocolitis in premature infants - an updated review. World J Clin Pediatr. 2019;8(2):23-32.
Jin, Y. T., Duan, Y., Deng, X. K., & Lin, J. (2019). Prevention of necrotizing enterocolitis in premature infants - an updated review. World Journal of Clinical Pediatrics, 8(2), pp. 23-32. doi:10.5409/wjcp.v8.i2.23.
Jin YT, et al. Prevention of Necrotizing Enterocolitis in Premature Infants - an Updated Review. World J Clin Pediatr. 2019 Apr 9;8(2):23-32. PubMed PMID: 31065543.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of necrotizing enterocolitis in premature infants - an updated review. AU - Jin,Yu-Ting, AU - Duan,Yue, AU - Deng,Xiao-Kai, AU - Lin,Jing, Y1 - 2019/04/09/ PY - 2018/08/25/received PY - 2018/12/31/revised PY - 2019/01/28/accepted PY - 2019/5/9/entrez PY - 2019/5/9/pubmed PY - 2019/5/9/medline KW - Empiric antibiotics KW - Human milk feeding KW - Necrotizing enterocolitis KW - Prevention KW - Probiotics KW - Standardized feeding protocols SP - 23 EP - 32 JF - World journal of clinical pediatrics JO - World J Clin Pediatr VL - 8 IS - 2 N2 - Necrotizing enterocolitis (NEC) is among the most common and devastating diseases encountered in premature infants, yet the true etiology continues to be poorly understood despite decades of research. Recently, gut bacterial dysbiosis has been proposed as a risk factor for the development of NEC. Based on this theory, several best clinical practices designed to reduce the risk of NEC have been proposed and/or implemented. This review summarizes the results of recent clinical trials and meta-analyses that support some of the existing clinical practices for reducing the risk of NEC in premature infants. It is evident that human milk feeding can reduce the incidence of NEC. While most of the studies demonstrated that probiotic supplementation can significantly reduce the incidence of NEC in premature infants, there are still some concerns regarding the quality, safety, optimal dosage, and treatment duration of probiotic preparations. Antibiotic prophylaxis does not reduce the incidence of NEC, and prolonged initial empirical use of antibiotics might in fact increase the risk of NEC for high-risk premature infants. Lastly, standardized feeding protocols are strongly recommended, both for prevention of postnatal growth restriction and NEC. SN - 2219-2808 UR - https://www.unboundmedicine.com/medline/citation/31065543/Prevention_of_necrotizing_enterocolitis_in_premature_infants_-_an_updated_review L2 - http://www.wjgnet.com/2219-2808/full/v8/i2/23.htm DB - PRIME DP - Unbound Medicine ER -