Epidemiology of Necrotizing Enterocolitis in Multiple Birth Preterm Infants in Switzerland

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ID: 315709
2026
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Abstract
Abstract Background Necrotizing enterocolitis (NEC) is a major cause of morbidity and mortality in preterm infants. Data comparing NEC incidence and outcomes between multiple birth and singleton preterm infants remains limited. Aims To report the incidence and mortality of NEC in preterm multiple-birth infants in Switzerland and to determine whether multiplicity independently contributes to NEC risk. Methods This is a retrospective cohort study analyzing data from the Swiss Neonatal Network collected between 2000 and 2021. A total of 16,411 preterm infants born at <32 weeks of gestational age were included, representing more than 95% of all Swiss preterm infants in this gestational age group (Figure I). Proven NEC cases, defined as Bell stage II or higher, were analyzed. NEC incidence and NEC-related mortality were compared between singleton and multiple birth preterm infants. Results 32.5% of the population consisted of infants from multiple births (5,330/16,411)(Figure I). The overall NEC incidence was low (2.7%). NEC incidence was comparable between singleton and multiple birth infants (2.8% vs. 2.6%). NEC-related mortality did not differ significantly between groups, (39.3%) in multiple births compared to (33.7%) in singletons (Figure II). In twin pairs, the risk of NEC in the second twin was sixfold higher if the first twin was affected (OR 6.1 (CI 95% 2.4 - 16.2)). Conclusion The overall incidence of NEC in Swiss preterm infants is comparatively low. No relevant differences in NEC incidence or mortality were observed between multiple birth and singleton preterm infants. However, there is an increased risk of NEC in the second twin following an affected first twin. This suggests shared environmental or biological risk factors within twin pairs and highlights the need for vigilant monitoring of co-twins following NEC diagnosis in one sibling.Figure 1For image description, please refer to the figure legend and surrounding text. Figure 2For image description, please refer to the figure legend and surrounding text.
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Authors M Milosevic, T Stalder, T Krause, M Minger, C Starvaggi, S Berger, M Adams, U Kessler
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag055.012
URL
https://doi.org/10.1093/bjs/znag055.012
Keywords Keywords not found

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