# Necrotizing Enterocolitis in Term Neonates: A Retrospective Chart Review from Children’s Medical Center, Tehran (2020–2023)

## TL;DR

This study examines the occurrence and risk factors of necrotizing enterocolitis in term neonates at a hospital in Tehran, finding a notable incidence and a link to herbal medication use.

## Contribution

The study identifies herbal medication intake as a potential risk factor for NEC in term neonates in Iran.

## Key findings

- The incidence of NEC in term neonates was 3.38% at the studied hospital.
- Abdominal distention was the most common initial symptom of NEC.
- Herbal medication intake was significantly higher in NEC cases compared to non-NEC cases.

## Abstract

Necrotizing enterocolitis (NEC) is one of the most life-threatening conditions affecting neonates admitted to the neonatal intensive care unit (NICU). Prematurity and low birth weight are the most widely recognized risk factors. However, NEC can also occur in term neonates. This study investigated the incidence, clinical presentation, and underlying medical conditions associated with NEC in term neonates at a tertiary referral children’s hospital in Tehran, Iran.

A retrospective review was conducted on term neonates diagnosed with NEC from 2020 to 2023. Data were collected on demographics, clinical presentation, laboratory findings, underlying medical conditions, treatment, and outcomes.

Of 975 term neonates admitted to the NICU during the study period, 33 were diagnosed with NEC, yielding an incidence of 3.38% (95% CI: 2.33–4.72). The mean birth weight was 3.15±0.57 kg, and NEC symptoms appeared at a mean age of 18.3±8.1 days. Abdominal distention was the most common initial symptom (78.8%). A history of herbal medication intake was reported significantly higher compared to non-NEC term neonates (P=0.02). Medical management was sufficient in 87.9% of cases, and no mortality was observed. The median hospital stay was 9 days (IQR: 7–13).

This study highlights a notable incidence of NEC among term neonates in a tertiary Iranian NICU and identifies herbal medication intake as a potential risk factor. These findings underscore the importance of early recognition and culturally sensitive preventive strategies in term infants, especially in regions where herbal remedies are commonly used.