Enterocolitis and congenital heart disease

Abstract

Congenital heart disease (CHD) represents a risk factor for necrotizing enterocolitis (NEC). To describe and compare the characteristics of infants with CHD who present either a NEC or an isolated digestive symptom. This retrospective single-center study included 67 infants with CHD under 3 months of age who presented with NEC ( n = 36, NEC group) or an isolated digestive symptom ( n = 31, No-NEC group) between January 2016 and December 2020 in the pediatric cardiology unit of the Lyon university hospital (France). CHD types were mainly coarctation of the aorta, pulmonary atresia, and transposition of the great arteries. Prostaglandin infusion was administered to 67.2% of infants, 73.1% had an umbilical venous catheter, 67.2% underwent cardiac surgery, 38.8% had a percutaneous interventional catheterization, and 11.9% had no intervention. NEC tended to be more frequent in infants who underwent palliative surgery or a prolonged discontinuation of prostaglandins compared to those who had a complete surgical repair. The cardiac intervention was performed later in the NEC group. Digestive events occurred more frequently before the cardiac intervention but in that case NEC was not more frequent although all the infants were fed. Mother's own milk was less frequently used in the NEC group, and the proportion of hypotrophic newborns and the use of fortified formula and antibiotics was higher in the NEC group. Cardiac procedure should not be delayed in order to prevent preoperative NEC. Careful feeding does not increase the incidence of NEC and the administration of mother's own milk or donor human milk should be promoted in this population.