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Necrotizing Enterocolitis in Children with Congenital Heart Disease: A Literature Review

Sean T Kelleher1, Colin J McMahon1, Adam James2

  • 1Department of Paediatric Cardiology, Children's Health Ireland at Crumlin, Dublin 12, Ireland.

Pediatric Cardiology
|September 12, 2021
PubMed

Insights

Infants with congenital heart disease (CHD) face a higher risk of necrotising enterocolitis (NEC). This review consolidates knowledge on NEC in CHD infants, exploring risks, outcomes, and prevention strategies.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Gastroenterology

Background:

  • Necrotising enterocolitis (NEC) is a severe intestinal condition, primarily linked to prematurity.
  • Congenital heart disease (CHD) is a significant risk factor for NEC in both preterm and term infants.
  • Current research on NEC in CHD infants is predominantly based on retrospective studies.

Purpose of the Study:

  • To consolidate existing knowledge on necrotising enterocolitis (NEC) in infants with congenital heart disease (CHD).
  • To explore incidence, pathophysiology, risk factors, outcomes, and the relationship between NEC and enteral feeds in this population.
  • To review potential preventative strategies, novel biomarkers, and the role of the intestinal microbiome in NEC among infants with CHD.

Main Methods:

  • Systematic literature review and knowledge consolidation.
  • Analysis of existing retrospective studies and relevant research.
  • Exploration of pathophysiological mechanisms and clinical data.

Main Results:

  • CHD is a key risk factor for NEC, particularly in term infants.
  • The relationship between NEC and enteral feeding in CHD infants is complex and requires further investigation.
  • Challenges in studying NEC in CHD infants include population heterogeneity and scarcity.

Conclusions:

  • Infants with CHD have an elevated risk of developing NEC.
  • Further research is warranted to identify at-risk infants and implement effective preventative strategies.
  • Understanding the multifactorial nature of NEC in CHD is crucial for reducing morbidity and mortality.

Keywords:
Congenital heart diseaseDuctal dependentMicrobiomeNECNecrotising enterocolitisNeonate

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