Children’s Healthcare of Atlanta Research Reveals Fewer Infants are Dying from NEC

ATLANTA (April 28, 2023) – Infant deaths from necrotizing enterocolitis (NEC) – a serious gastrointestinal condition that primarily affects premature babies – have decreased since 2007, but Black infants are much more likely to die from NEC than white infants.

These were among the key findings from research conducted at Children’s Healthcare of Atlanta and Emory University School of Medicine, and recently published in the JAMA Network Open medical journal.

The research team examined records from the US Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics’ 2020 Final Multiple Cause of Death Data of more than 88 million live births between 1999 and 2020, during which time 8,951 infants died of NEC. The study revealed that while NEC-related deaths increased early in the 21st century, NEC-related deaths declined by 7.7% each year from 2007 through 2012. However, no further declines were seen in the years hence. The study findings translate to one infant each day dying of NEC in the US.

The study also found that while the racial differences in the death rate have narrowed, Black infants were still 2.5 times more likely to die from NEC than white infants in 2020. The research team also analyzed death rates from a geographic (state-by-state) perspective.

Co-authoring the study were neonatologist Mattie F. Wolf, MD, Division of Neonatology, Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta; and Ravi Patel, MD, MSc, a neonatologist at Children’s Healthcare of Atlanta and Associate Professor of Pediatrics at Emory University School of Medicine.

“While great strides have been made in understanding, preventing and treating NEC, progress in preventing mortality due to NEC seems to have stalled in recent years,” said Dr. Wolf. “In addition, racial and ethnic disparities still exist. Further studies are warranted to examine factors mediating these results, including the role of increasing donor human milk use.”

NEC is the most common cause of death between two weeks and two months of age in extremely preterm infants. It occurs when tissue in the small or large intestine is injured or inflamed, which can lead to death of intestinal tissue and sometimes a perforation in the intestine. Bacteria in the intestine can also travel into the bloodstream, causing life-threatening infections. Some babies who do recover from NEC face lifelong neurological and nutritional challenges.

The study was supported by funding from the National Institutes of Health (NIH).

Dr. Wolf will be presenting these findings at the Pediatric Academic Societies Conference this upcoming weekend in Washington, D.C. Dr. Patel will also be presenting his work related to NEC at the conference and discussing tools available for diagnosis NEC earlier.