Background: Necrotizing enterocolitis is one of the most common serious surgical disorders of neonates. It is a life-threatening emergency of the gastrointestinal tract in the neonatal period that causes morbidity and mortality of newborns. Although the burden of the disease is high and it is the major cause for neonatal death, there is limited information’s about identifying the determinant factors that may help to reduce the neonatal deaths. Thus this study aimed to identify the determinants of necrotizing enterocolitis among admitted neonates in neonatal intensive care unit at referral hospitals of East and West Gojjam Zones of Amhara regional state,Northwest Ethiopia, 2020.
Methods: Unmatched case control study design was conducted among 246 neonates (82 cases and 164 controls) in neonatal intensive care unit from February 24 to April 24, 2020. Data was collected through face to face interview and reviewing medical charts of the neonates. Data was entered into Epi data and exported to SPSS for analysis. Bivariable logistic regression analysis was used to identify the candidate variables at p≤0.25 and multivariable logistic regression analysis was employed to identify significant determinants at p value <0.05. Adjusted odds ratio with 95% CI was used to show the strength of association between exposure and outcome variables.
Result: A total of 246 neonates were included in the study. Duration of rupture of membrane>18 hours [AOR=4.287; 95%CI (2.157-8.518)], low birth weight [AOR= 3.592; 95% CI (1.742- 7.407)], neonatal sepsis [AOR=3.553; 95% CI (1.76-7.174)] and types of enteral feeding (formula milk only [AOR=3.604; 95% CI (1.548-8.39)] and mixed milk (AOR=2.416; 95% CI (1.103-5.290)]) were determinants for necrotizing enterocolitis.
Conclusions: Duration of rupture of membrane, low birth weight, neonatal sepsis and enteral feedings (formula milk and mixed milk) were significantly associated with necrotizing enterocolitis. Encouraging exclusive breastfeeding, providing adequate care for low birth weight babies and using septic precautions to avoid neonatal sepsis are the strategies to prevent necrotizing enterocolitis.