Risk factors and outcomes of NEC in preterm and low birth weight infants with a congenital heart defect

Abstract

In this study population of 64 preterm and LBW infants with CHD, the incidence of NEC was substantially higher than the general population. This incidence coincides with the experience that prematurity, LBW and CHD increase the risk for NEC up to 100- fold. This study population exclusively consisted of vulnerable preterm infants under 35 weeks of GA which explains the high incidence of NEC in this population. The predisposing conditions for NEC in this population of preterm and LBW infants with CHD were invasive ventilation, received CPR and sepsis preoperatively, and duration of 1st invasive ventilation, PHT and iNO treatment postoperatively. Factors with noticeable difference between the NEC and no-NEC group were gestational age, birth weight, type of feeding and surgical characteristics. These results should be carefully interpreted due to lack of power. As expected, NEC significantly increased the risk of mortality in the infants of this study population, the deaths directly or indirectly attributed to NEC or its complications. This study ads to the understanding of the ambiguity of many different variables. The results of this study will hopefully support future risk factor studies, act as a basis for prospective and multicenter studies and will hopefully add to future preventive strategies.