Abstract: 　Objective　To analyze the risk factors of neonatal necrotizing enterocolitis (NEC) in twins. Methods　Medical records of twins, of which only one suffered from NEC charged in Xiangya Hospital between 2012 and 2018 were retrospectively reviewed. The enrolled twins were divided into NEC group and non-NEC group. The potential risk factors of NEC including basic information (birth weight, asphyxia after birth, birth order, gender) and risk factors (enteral feeding, medical treatments, relevant diseases) were compared between the two groups. Results　The rate of feeding intolerance (65.9% vs. 40.9%, χ2=5.526, P=0.019), red cell concentration by infusion within 48 hours before NEC occurred (27.3% vs. 6.8%, χ2=6.510, P=0.011) were significantly higher in twins with NEC than those without NEC. The lowest hemoglobin content in the first week after birth (114.9±19.5 g/L vs. 127.7±24.0 g/L, P<0.001) were significantly lower in twins with NEC than those without NEC. Conditional logistic regression analysis showed that the independent risk factors of NEC were feeding intolerance (P=0.018, OR=7.264, 95%CI:1.397~37.766), early anemia (P=0.022, OR=10.208, 95%CI:1.408~74.009) and red cell concentration by infusion within 48 hours before NEC occurred (P=0.023, OR=16.648, 95%CI: 1.473~188.094). Conclusions　Feeding intolerance, early anemia and red cell concentration by infusion within 48 hours before NEC occurred were independent risk factors of NEC.

Key words: neonatal necrotizing enterocolitis;　risk factors;　twins;　premature