Objective To explore the risk factors for poor prognosis of neonatal necrotizing enterocolitis (NEC).Methods The clinical data of 83 newborns with NEC (Bell stage>Ⅱ),who were treated in our hospital from Jan.2017 to Dec.2018,were analyzed retrospectively.According to the prognosis of NEC,the newborns were divided into observation group (with poor prognosis,requiring surgery,giving up treatment,or death) and control group (cured).The general data,perinatal factors,feeding before onset,treatment,laboratory auxiliary examination at onset and clinical manifestations of newborns in the 2 groups were analyzed by univariate and multivariate logistic regression analyses.Results Among the 83 NEC newborns,there were 28 cases (33.7%) in the observation group and 55 cases (66.3%) in the control group,with significant differences between the 2 groups in gestational age,birth weight,incidence of patent ductus arteriosus,time of NEC onset,first time of feeding,proportions of antenatal steroid administration,umbilical vein catheters,ibuprofen administration and prophylactic antibiotics administration,as well as white blood cell (WBC) count,platelet count,immature/total neutrophil ratio,procalcitonin level,proportion of positive blood culture and proportion of abdominal distention at onset (all P<0.05).Multivariate logistic regression analysis showed that increased gestational age (odds ratio[OR]=0.68) and WBC count at onset (OR=0.81) were protective factors,and procalcitonin>10 ng/mL at onset (OR=7.32) was a risk factor for poor prognosis of NEC (all P<0.05).Conclusion The increased gestational age and WBC count at onset are protective factors for the poor prognosis of NEC,and procalcitonin >10 ng/mL at onset is a risk factor for the poor prognosis of NEC.