684 - Epidemiological Trends in Infant Mortality Related to Necrotizing Enterocolitis

Publication Number: 1661.684

Sowmya P. Kolluru, Creighton University School of Medicine, Omaha, NE, United States; Natalie M. Liao, Creighton University School of Medicine, Omaha, NE, United States; Kennedy A. Haase, Creighton University School of Medicine, Omaha, NE, United States; Abubakar Tauseef, Creighton University School of Medicine, Elkhorn, NE, United States

Background: Necrotizing enterocolitis (NEC) is the leading cause of gastrointestinal morbidity and mortality among infants in the neonatal intensive care unit. With an overall prevalence of 1%, NEC is found in about 11% of infants with very low birthweights and double that in infants of extremely low birthweights. A disease of prematurity, NEC has a multifactorial pathogenesis involving a combination of feeding regimens, gut microbiome, and birth weight. NEC remains a significant diagnostic challenge, as it presents similarly to septic ileus and intestinal perforation. Preliminary research into genomic and proteomic biomarkers of disease holds promise for future diagnostic accuracy, but given NEC’s devastating burden and complications, further research is needed to better characterize the factors implicated in its pathogenesis.

Objective: This study aims to elucidate the demographic factors associated with NEC-mediated infant mortality, with the goal of guiding future research into disease diagnosis and management.

Design/Methods: The CDC WONDER database was queried to collect data on mortality from NEC in infants < 1 year old between 1999-2023. Data was stratified by sex, race and ethnicity, urbanization status, and census region. Crude mortality rate (CMR) was determined and Joinpoint analysis was conducted to identify significant changes to trends in mortality.

Results: Overall, CMR decreased slightly over the study period of 1999 to 2023. Between male and females, CMR was higher in males across the study period, though mortality decreased slightly in this population. On the other hand, there was a negligible increase in CMR among females. When stratifying by race, Non-Hispanic Black or African American patients had the highest CMR throughout the study period, followed by Hispanic or Latino and Non-Hispanic White patients, respectively. Regionally, the South had the highest CMR across the four studied census regions, though mortality decreased over the study period. The West reported the lowest mortality from NEC and was the only census region with reported increase in CMR. Regardless of urbanization status, mortality initially increased before a subsequent decrease through the study period.

Conclusion(s): Our study builds on prior research efforts into mortality trends in NEC and highlights the disproportionate mortality burden faced by certain demographic groups. Further studies into the implications of different socioeconomic determinants of health and biomarker variability by demographic cohort can guide more effective diagnostic and management strategies.