Abstract
Background: Necrotizing enterocolitis is the leading gastrointestinal cause of morbidity and mortality in neonatal intensive care units. Despite advancements in neonatal care, the incidence of NEC remains unchanged. This study evaluated trends in NEC incidence and severity over the past decade and identified associated risk factors in our NICU population. Methods: This was a retrospective cohort study comparing the prevalence and severity of NEC among VLBW infants born before 32 weeks of gestation across the following two periods: 2012-2016 and 2017-2021. Clinical data were extracted from medical records, with NEC diagnosis and grading based on the modified Bell's criteria. Results: A total of 299 infants were included. Those born in the later period were significantly more preterm and had lower birth weights. While the overall NEC incidence increased in the later cohort, the rate of surgical NEC was lower. Logistic regression identified hemodynamic instability requiring pressor support, late-onset sepsis, and earlier gestational age as significant risk factors for NEC. Conclusions: Although the incidence of NEC was higher in the later cohort, its severity was lower compared to the earlier cohort. These findings suggest that advancements in neonatal care and feeding protocols may contribute to improved outcomes. Early NEC stages may represent alternative intestinal or systemic conditions warranting further research for better diagnosis.