PREDISPOSING FACTORS ASSOCIATED WITH NECROTIZING ENTEROCOLITIS AMONG PRETERM NEWBORNS

Abstract

Introduction: Neonatal necrotizing enterocolitis is a clinical emergency characterized by severe intestinal inflammation or necrosis and is associated with high morbidity and mortality among newborns. Objective: To describe the predisposing factors associated with necrotizing enterocolitis among preterm newborns. Methodology: This is an integrative literature review based on materials indexed in the Virtual Health Library Portal (VHL):  Medical Literature Analysis and Retrieval System Online (MEDLINE), Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Index Medicus for the Western Pacific (WPRIM) and Latin American and Caribbean Literature in Health Sciences (LILACS), using the Health Sciences Descriptors (DeCS) crossed with the Boolean operator AND, as follows: Necrotizing Enterocolitis AND Risk Factors AND Newborn. The inclusion criteria: primary and original studies, published in full text between January 2015 and January 2025, in English, Portuguese, Korean, Chinese and Spanish, related exclusively to the subject of the study, finding 559 articles. Exclusion criteria: articles of the literature review type, theses, dissertations, monographs, case studies and publications that did not contain the full text available in the research sources free of charge. Subsequently, the titles and abstracts were carefully read, followed by the eligible articles in their entirety, discarding articles according to the exclusion criteria. After applying the eligibility criteria, 16 studies were selected to make up this review. Results: Different risk factors were found to be associated with necrotizing enterocolitis among newborns, such as systemic infections like early sepsis and urinary tract infections, extreme prematurity, intestinal dysbiosis, hemodynamic instability, severe anemia, blood transfusions and patent ductus arteriosus. In addition, the absence of breast milk in the diet and prolonged use of mechanical ventilation and invasive catheters are also strongly associated with increased risk. Final considerations: The multifactorial complexity of necrotizing enterocolitis in neonates has been observed, making it essential to implement integrated monitoring and prevention strategies. Early identification of neonates at risk, combined with strict control of predisposing factors, can contribute to reducing the morbidity and mortality associated with the disease.