与坏死性小肠结肠炎有关的婴儿死亡率的流行病学趋势
Epidemiological trends in infant mortality related to necrotizing enterocolitis.
摘要(中文译文)
坏死性小肠结肠炎（NEC）是新生儿重症监护病房中婴儿胃肠道疾病发病和死亡的主要原因。NEC的总体患病率为1%，在极低出生体重（VLBW）婴儿中约为11%，在超低出生体重婴儿中为22%。作为一种早产儿疾病，NEC的发病机制涉及多种因素，包括喂养方案、肠道微生物组和出生体重的共同作用。本研究旨在阐明与NEC所致婴儿死亡相关的人口学因素，以期为未来疾病诊断和管理的研究提供指导。研究查询了CDC WONDER数据库，收集1999年至2023年间1岁以下婴儿NEC死亡数据。数据按性别、种族/民族、城市化状况和人口普查区域进行分层。计算粗死亡率（CMR），并进行Joinpoint分析以识别死亡率趋势的显著变化。1999年至2023年间，NEC相关总体CMR略有下降。研究期间男性CMR始终高于女性，但男性人群死亡率略有下降。按种族分层，非西班牙裔（NH）黑人或非裔美国患者总体CMR最高，其次分别为西班牙裔或拉丁裔和NH白人患者。在区域方面，南部在四个研究普查区域中CMR最高，但南部死亡率在研究期间有所下降。西部报告的NEC死亡率最低，且是唯一报告CMR上升的普查区域。在城市和农村地区，死亡率在研究期间均先上升后下降。本研究在既往NEC死亡率趋势研究的基础上，揭示了特定群体所面临的NEC相关不成比例的死亡负担，包括男性、NH黑人或非裔美国患者以及美国南部患者。进一步研究不同社会经济健康决定因素的影响以及各人口学队列间生物标志物的变异性，可为制定更有效的诊断和管理策略提供指导。
Abstract
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 (VLBW) and 22% 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. 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. The CDC WONDER database was queried to collect data on mortality from NEC of infants <1 year old between 1999 and 2023. Data was stratified by sex, race/ethnicity, urbanization status, and census region. Crude mortality rate (CMR) was determined, and Joinpoint analysis was conducted to identify significant changes in mortality trends. Overall NEC-related CMR decreased slightly between 1999 and 2023. CMR was higher in males than females throughout the study period, though mortality decreased slightly in the male population. When stratified by race, Non-Hispanic (NH) Black or African American patients had the highest overall CMR, followed by Hispanic or Latino and NH White patients, respectively. Regionally, the South had the highest CMR across the four studied census regions, though Southern 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. In both urban and rural areas, mortality initially increased before a subsequent decrease throughout the study period. This study builds on prior research efforts into mortality trends in NEC to highlight the disproportionate mortality burden associated with NEC faced by certain groups, including males, NH Black of African American patients, and patients from the Southern United States. Further research into the implications of different socioeconomic determinants of health and biomarker variability by demographic cohort can guide more effective diagnostic and management strategies.
如何引用
AMA
Sowmya Kolluru, Natalie Liao, Kennedy Haase, Olivia Foley, Lillia Cherkasskiy, Abubakar Tauseef. Epidemiological trends in infant mortality related to necrotizing enterocolitis.. Frontiers in pediatrics. 2026; doi:10.3389/fped.2026.1825909.
APA
Sowmya Kolluru, Natalie Liao, Kennedy Haase, Olivia Foley, Lillia Cherkasskiy, Abubakar Tauseef (2026). Epidemiological trends in infant mortality related to necrotizing enterocolitis.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2026.1825909
GB/T 7714
Sowmya Kolluru, Natalie Liao, Kennedy Haase, Olivia Foley, Lillia Cherkasskiy, Abubakar Tauseef. Epidemiological trends in infant mortality related to necrotizing enterocolitis.[J]. Frontiers in pediatrics, 2026 doi:10.3389/fped.2026.1825909.
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