What question did this study set out to answer?

This research aims to identify risk factors for necrotizing enterocolitis in very low birth weight infants to improve clinical outcomes.

February 9, 2026Open Access

Risk factors of necrotizing enterocolitis in very low birth weight infants: a meta-analysis

Key Points

This research aims to identify risk factors for necrotizing enterocolitis in very low birth weight infants to improve clinical outcomes.
Conducted a systematic search across multiple databases for relevant studies.
Included case-control, cohort, and cross-sectional studies.
Performed quality assessments using NOS and AHRQ scores.
Data pooled using Stata 15 software with a random-effects model.
Small gestational age is associated with a 35% higher risk of NEC.
Red blood cells transfusion increases the risk by 75%.
Maternal hypertensive disorders are linked to a 27% increased risk.
Patent ductus arteriosus raises risk by 56%.
Sepsis is associated with an 87% higher risk of NEC.

Abstract

Background This study aims to explore the primary risk factors for necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants through meta-analysis, providing scientific evidence for clinical prevention and treatment. Methods A systematic search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases for studies investigating risk factors for NEC in VLBW infants, covering the period from database inception to October 10, 2025. Eligible studies included case-control studies, cohort studies, and cross-sectional studies meeting the inclusion criteria. Quality assessment was performed using the NOS and AHRQ scores. Data were pooled using Stata 15 software with a random-effects model. Results a total of 16 research articles involving 179,289 patients included, meta-analysis results suggest that Small Gestational Age OR = 1.35, 95% CI (1.14, 1.60), red blood cells transfusion OR = 1.75, 95% CI (1.26, 2.43), maternal hypertensive disorders OR = 1.27, 95% CI (1.03, 1.57), patent ductus arteriosus OR = 1.56, 95% CI (1.30, 1.88), sepsis OR = 1.87, 95% CI (1.22, 2.87) were associated with NEC in very low birth weight infants. Conclusion This systematic meta-analysis consolidates and confirms previously reported associations between several clinical factors and the risk of necrotizing enterocolitis in very low birth weight infants. The findings support the association of small gestational age, red blood cell transfusion, maternal hypertensive disorders, patent ductus arteriosus, and sepsis with an increased risk of NEC. Systematic Review Registration PROSPERO CRD420251149565.

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