ABSTRACT
T he pathogenesis of necrotizing enterocolitis remains incompletely understood despite considerable research efforts. In some patients, an intense exposure to a single specific risk factor appears to be temporally linked to the onset o f necrotizing enterocolitis. For example, necrotizing enterocolitis in infants following exchange transfusion or birth asphyxia strongly suggests impaired blood flow or oxygen delivery as a pathogenic mechanism. A necrotizing enterocolitis-like illness may be caused by enteric infection with Clostridium perfringens, implying that some cases may be due to infection. However, the two factors most consistently associated with the development o f necrotizing enterocolitis are prematurity and feeding. Approximately 90% o f infants who develop necrotizing enterocolitis are premature infants who have been fed. A better understanding o f how prematurity and feeding put the neonate at increased risk o f developing necrotizing enterocolitis would assist in the designing strategies to prevent and to better treat this potentially devastating illness.
