Association of closure of patent ductus arteriosus and development of necrotizing enterocolitis

Over a 5-year period ending in June 1986, 234 neonates with evidence of a significant patent ductus arteriosus (PDA) underwent ductal manipulation. Thirty-four infants (15%) developed evidence of necrotizing enterocolitis (NEC). When NEC and treatment of PDA were within 72 hours of each other, there was a 71% mortality rate. When NEC and PDA ligation were greater than 72 hours apart, there were no deaths. Development of NEC prior to ductal closure was associated with a mortality of 57%, as opposed to no mortality when the development of NEC occurred after ductal closure. Our data suggest that infants who develop NEC before PDA ligation incur a high mortality.