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The association of congenital heart disease with necrotizing enterocolitis in preterm infants: a birth cohort study

Journal of Perinatology volume 35, pages 949–953 (2015)Cite this article

Subjects

Abstract

Objective:

To test the hypothesis that congenital heart disease (CHD) in preterm infants with severe CHD (cyanotic or left-sided obstructive lesions, or congestive heart failure) is independently associated with necrotizing enterocolitis (NEC, stage II or greater).

Study design:

Single-institution retrospective birth cohort of preterm infants with gestational age 230/7 to 346/7 weeks delivered between 1 January 2002 and 31 December 2011, excluding infants who received comfort care. Patients were classified into severe CHD, mild CHD and control groups.

Results:

Among 4678 infants, 170 (3.6%) had CHD and 118 (2.5%) developed NEC. The risk for NEC increased with severe CHD (adjusted relative risk (RR)=3.72; 95% confidence interval (CI)=1.37 to 10.10) but not with mild CHD (RR=0.65; CI=0.27 to 1.55).

Conclusion:

In this cohort, severe but not mild CHD was independently associated with increased risk for NEC. This finding, if confirmed by other studies, may help identify patients at risk for NEC.

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Author information

Author notes

  1. C Motta: Current affiliation: Pediatrix Medical Group, San Antonio, TX, USA.

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA,

    C Motta, M Wyckoff, P J Burchfield & L P Brion

  2. Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA,

    W Scott & L Mahony

  3. Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA,

    J Koch

  4. Division of Biostatistics, Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA

    J Reisch

Authors
  1. C Motta
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  2. W Scott
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  3. L Mahony
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  4. J Koch
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  5. M Wyckoff
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  6. J Reisch
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  7. P J Burchfield
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  8. L P Brion
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Corresponding author

Correspondence to L P Brion.

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Competing interests

The authors declare no conflict of interest.

Additional information

This project was presented as an abstract at the following meetings. Brion LP, Wyckoff MH: Association of congenital heart disease (CHD) with mortality and morbidity in preterm infants. Poster presentation at the Pediatric Academy Societies, Baltimore, MD, 4 May 2009. Motta C, Scott W, Mahony L, Koch J, Reisch J, Burchfield J, Wyckoff M and Brion L: Association of Congenital Heart Disease and Necrotizing Enterocolitis in Preterm Infants. Poster presentation at the AAP Perinatal and Developmental Symposium, Aspen, CO, June 2013. Motta C, Scott W, Mahony L, Koch J, Reisch J, Burchfield J, Wyckoff M and Brion L: Association of Congenital Heart Disease and Necrotizing Enterocolitis in Preterm Infants. Poster presentation at the AAP National Conference and Expedition, Orlando, FL, 25 October 2013. Motta C, Scott W, Mahony L, Koch J, Reisch J, Burchfield J, Wyckoff M and Brion L: Association of Congenital Heart Disease and Necrotizing Enterocolitis in Preterm Infants. Platform presentation at the AAP Section on Perinatal Pediatrics 20th South Central Conference on Perinatal Research, Austin, TX, 29–31 October 2013.

Author contributions

C Motta: conceptualized and designed the study. She merged data from all databases, reviewed medical records, participated in the interpretation of the data, drafted the first version of the manuscript, critically reviewed the revisions and approved the final manuscript as submitted. W Scott, L Mahony, J Koch and M Wyckoff: conceptualized and designed the study; participated in the interpretation of the data, critically reviewed the manuscript and approved the final manuscript as submitted. J Reisch: consulted and selected the analyses to be used. She participated in the interpretation of the data, critically reviewed the manuscript and approved the final manuscript as submitted. PJ Burchfield: collected and entered data into the databases and extracted the data for the Parkland cohort; she participated in the interpretation of the data, critically reviewed the manuscript and approved the final manuscript as submitted. LP Brion: conceptualized and designed the study. He conducted statistical analyses, participated in the interpretation of the data, critically reviewed and revised the manuscript and approved the final manuscript as submitted.

Supplementary Information accompanies the paper on the Journal of Perinatology website

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Motta, C., Scott, W., Mahony, L. et al. The association of congenital heart disease with necrotizing enterocolitis in preterm infants: a birth cohort study. J Perinatol 35, 949–953 (2015). https://doi.org/10.1038/jp.2015.96

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