At the limit of viability: Outcomes of necrotising enterocolitis in neonates born before 25 weeks' gestation.

Cohort studyJournal of pediatric surgery· Jul 2026

At the limit of viability: Outcomes of necrotising enterocolitis in neonates born before 25 weeks' gestation.

Mohamad E Abdullah, Kamil Ali, Manimaran Jayamurthy … Stewart Cleeve

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Pediatric SurgeryCohort studyQ1IF 2.1

Neonates born ≤25 weeks with necrotising enterocolitis had 76.5% overall survival

At the limit of viability: Outcomes of necrotising enterocolitis in neonates born before 25 weeks' gestation.

Mohamad E Abdullah … Stewart Cleeve

Journal of pediatric surgery · Jul 2026 · Q1 in Surgery

Purpose

To determine management outcomes and prognostic indicators for necrotising enterocolitis (necrotising enterocolitis) in extremely premature neonates born at the threshold of viability (≤25 weeks).

Methods

A retrospective review of a prospectively maintained, consecutively recorded database of neonates born ≤25 weeks' gestation admitted with necrotising enterocolitis to a tertiary neonatal unit between January 2020 and December 2025.

n = 51 neonates

Results

over three in four extremely preterm infants with necrotising enterocolitis survived to discharge

Surgical

77.1%

Medical

75%

More results

Mean GA was 24 weeks and BW 667 g, with male predominance (60.8%).

35 (68.6%) underwent surgical intervention, and 16 (31.4%) were managed medically.

At the time of diagnosis, CRP was normal in 54.9%, and thrombocytopenia occurred in 56.8%.

More results

Among survivors, CLD affected 83.8%, tube feeding dependency 29.7%, and Grade 3/4 IVH 13.5%.

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Conclusion · 1 of 2

Necrotising enterocolitis in neonates born at the threshold of viability show promising survival, implying that extreme prematurity shouldn't exclude surgical treatment.

Conclusion · 2 of 2

Survivors experience significant comorbidities, especially chronic respiratory and nutritional morbidity. Collecting long-term neurodevelopmental data is crucial for family counselling and future care.

At the limit of viability: Outcomes of necrotising enterocolitis in neonates born before 25 weeks' gestation.

At the limit of viability: Outcomes of necrotising enterocolitis in neonates born before 25 weeks' gestation.

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