Abstract

Introduction

Necrotizing enterocolitis (NEC) is one of the leading gastrointestinal emergencies causing significant morbidity and mortality in premature neonates. This study aimed to evaluate the effectiveness of the GutCheck-NEC (GCN) and e-NEC scoring systems in predicting necrotizing enterocolitis (NEC) in premature infants with a gestational age (GA) ≤32 weeks.

Materials and Methods

This prospective observational study was conducted between January 2020 and December 2021 in the Neonatal Intensive Care Unit of Gazi University Faculty of Medicine. A total of 60 premature infants with GA ≤32 weeks were included. All cases were assessed using the GCN and e-NEC scores on days 3, 7, 14, 21, and 28 of life. NEC development was compared with these scores and other potential risk factors.

Results

NEC of Bell stage ≥2 developed in 14 (23.3%) infants. GCN scores were significantly higher in infants who developed NEC on the 72nd hour, 14th day, and 21st day (p-values: 72nd hour: 0.014; 14th day: 0.032; 21st day: 0.047). In our study, the low and moderate risk groups according to the GCN score were combined as the “low-risk” group, and the high and very high-risk groups were classified as “high-risk.” A significant difference in NEC development was found between the low-risk and high-risk groups on the 72nd hour of life (p=0.046). The e-NEC score did not show a significant difference in distinguishing between infants with and without NEC. Breastfeeding was found to be protective against NEC (p=0.026).

Conclusion

The GCN score may be a useful tool in predicting NEC in premature infants in clinical practice. The e-NEC score, on the other hand, may be used to raise awareness in nursing follow-ups.