Epidemiology of Necrotizing Enterocolitis in Qatar: An Analysis of a local Registry

A Alsaied*, H Salama*, H Alrifai*, M Alqubaisy*, S Alobaidly*, L Thalib**

*Hamad Medical Cooperation, Doha, Qatar
**Department of Public Health, Qatar University, Doha, Qatar

Authors: Amer Alsaied, Hussam Salama, Hilal Alrifai, Mai Alqubaisy, Sawsan Alobaidly, Lukman Thalib

Address for correspondence:

Dr. Amer Alsaied

Pediatric Surgeon

Hamad Medical Corporation

Doha

Qatar

Phone: +974 66077366

Email: aalsaied1@haamd.qa

ABSTRACT

Necrotizing Enterocolitis (NEC) is a major source of morbidity and mortality in the Neonatal Intensive Care Unit NICU. Aim: To quantify the incidence of NEC among Very Low Birth Weight (VLBW) infants in Qatar and to identify the risk factors associated with NEC. Methods: The incidence is computed using a population-based cohort of all newborns captured in the (the PEARL-Peristat Newborn Registry) at Hamad Medical Corporation (HMC). The registry data was further analyzed to identify the risk factors that are associated with NEC in Qatar’s neonatal population using the appropriate regression models. Results: The local incidence of NEC was 5.0% (95% CI: 3.4%-7.5%) in the study population. A number of risk factors were identified to be protective among neonates in Qatar. Breast-feeding (OR: 0.17; 95%CI: 0.03-0.96) was found to significantly reduce the risk of NEC compared to formula feeding after adjusting for gestational age and birthweight. As expected, increased gestational age (OR:0.88; 95% CI: 0.83-0.93 per week) and larger birthweight (OR:0.83; 95% CI: 0.76-0.90 per 100 g) were found to be protective. Breast-feeding was also found to improved survival among neonates in Qatar. The hazard of death among the breast-fed infants was significantly lower compared to formula fed neonates 0.06 (95% CI: 0.016-0.21). Conclusion: Lack of breast-feeding was confirmed to be risk factors for NEC in our population. Presence of breast-feeding was not only a protective factor but also improved overall survival of neonates in Qatar. If similar findings are confirmed through high quality intervention studies, breast-feeding may play a vital role in curbing the incidence of NEC.

Approval from IRB at HMC has been granted: HMC-IRB, 3064/13.02Jan17-19Jun17. QU IRB: QU-IRB 868-E/18.

Keywords: Necrotizing Enterocolitis, Very Low Birth Weight Infants, Prematurity, Breast Feeding

Epidemiology of Necrotizing Enterocolitis in Qatar: An Analysis of a local Registry

A Alsaied*, H Salama*, H Alrifai*, M Alqubaisy*, S Alobaidly*, L Thalib**

*Hamad Medical Cooperation, Doha, Qatar
**Department of Public Health, Qatar University, Doha, Qatar

Anahtar Kelimeler: Necrotizing Enterocolitis, Very Low Birth Weight Infants, Prematurity, Breast Feeding