Finally, ELBW survival often depends on intubation at birth, potentially increasing the risk of infections, including NEC. Prolonged intubation may result in chronic inflammation of the airways. This inflammation may then predispose the infant to recurrent septic work-ups and repeated exposure to antibiotics. Overuse of antibiotic has been associated with NEC. A decrease in pulmonary reserve and respiratory decompensation, which requires increased respiratory support, may lead to intestinal injury, but further evidence is required before a causal relationship can be determined.