A regional study of underlying congenital diseases in term neonates with necrotizing enterocolitis.
OBJECTIVE
The aetiology of necrotizing enterocolitis (NEC) remains poorly understood in infants of all gestation, particularly when it occurs at term. We hypothesize that NEC in term infants is rare but often associated with underlying congenital illnesses.


METHODS
Records of all term infants hospitalized with radiologically or surgically proven NEC in the 10 tertiary centres of two geographical regions of Australia during a 6.5-y period were reviewed. Regional birth data were obtained and a special care nursery survey was conducted.


RESULTS
Twenty-nine infants had proven NEC giving a population incidence of 0.05 per 1000 live births. Nineteen (66%) of them had underlying congenital diseases. Five (17%) infants had endocrine disorders, which included panhypopituitarism, hypothyroidism, hypoparathyroidism and congenital adrenal hyperplasia. Ten infants had congenital heart disease, eight being cyanotic. Six of them developed NEC prior to any invasive cardiac procedures. Seven of the other nine infants without any congenital diseases had perinatal risk factors associated with NEC. The severity of illness was not different amongst the three groups. All infants, except two, survived.


CONCLUSIONS
NEC in term infants is commonly secondary to or preceded by underlying congenital diseases. A considerable proportion of NEC cases had co-existing endocrine illnesses.
Bolisetty
S
S
Royal Hospital for Women, University of New South Wales, Sydney, Australia.
Lui
K
K
Oei
J
J
Wojtulewicz
J
J
D001724:Birth Weight; D004700:Endocrine System Diseases / Q000150:complications* / Q000151:congenital / Q000453:epidemiology; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate