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

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.