Necrotising enterocolitis suspicion in newborns with duct-dependent congenital heart disease: prognosis and risk factor

BMJ Paediatr Open. 2024 Sep 15;8(1):e002520. doi: 10.1136/bmjpo-2024-002520.

Abstract

Introduction: The main risk factors of necrotising enterocolitis (NEC) are prematurity and low birth weight. The aim of our study was to identify risk factors for NEC in patients with duct-dependent congenital heart disease (CHD).

Study design: Newborns with duct-dependent CHD and NEC were matched 1:1 to those without NEC. Matched criteria were gestational age, birth weight, antenatal versus postnatal diagnosis and type of CHD.

Results: Twenty-three infants were included in each group. In the NEC group, mortality, length of intensive care unit stay and length of hospital stay were significantly higher (p=0.035; p<0.0001; p<0.0001). Lower diastolic blood pressure (DBP), negative flow balance, peritoneal dialysis and epinephrine-infusion were significantly associated with NEC (respectively, p=0.008, p=0.002, p=0.007, p=0.017). In multivariate analysis, DBP≤30 mm Hg remained the only independent risk factor of NEC (OR=8.70; 95% CI (1.46 to 53.50), p=0.019).

Conclusion: A DBP lower than 30 mm Hg was in our matched population of newborns with duct-dependent CHD, independently associated with NEC.

Keywords: Cardiology; Neonatology.

MeSH terms

  • Enterocolitis, Necrotizing* / diagnosis
  • Enterocolitis, Necrotizing* / epidemiology
  • Enterocolitis, Necrotizing* / mortality
  • Female
  • Gestational Age
  • Heart Defects, Congenital* / complications
  • Heart Defects, Congenital* / diagnosis
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Length of Stay
  • Male
  • Prognosis
  • Retrospective Studies
  • Risk Factors