title: Risk of necrotizing enterocolitis in very-low-birth-weight infants with isolated atrial and ventricular septal defects.
abstract: OBJECTIVE
  Necrotizing enterocolitis (NEC) is associated with a significant morbidity and mortality in premature infants. We sought to identify the frequency of NEC in very-low-birth-weight infants with isolated ventricular septal defects (VSDs) or atrial septal defects (ASDs) using a large multicenter database.
  
  
  METHODS
  We identified a cohort of infants with birth weight <1500 g cared for in 312 neonatal intensive care units (NICUs) managed by the Pediatrix Medical Group between 1997 and 2010. We examined the association between the presence of an ASD or a VSD with development of NEC using logistic regression to control for small-for-gestational age status, antenatal steroid use, antenatal antibiotic use, gestational age, sex, race, Apgar score at 5 min and method of delivery.
  
  
  RESULTS
  Of the 98 523 infants who met inclusion criteria, 1904 (1.9%) had an ASD, 1943 (2.0%) had a VSD and 146 (0.1%) had both. The incidence of NEC was 6.2% in infants without septal defects, 9.3% in those with an ASD, 7.8% in those with a VSD, and 10.3% in infants with both an ASD and a VSD. Compared with infants without septal defects, the adjusted odds ratios for developing NEC for each group-ASD alone, VSD alone and ASD with VSD-were 1.26 (95% confidence interval 1.07 to 1.49), 1.27 (1.07 to 1.51) and 1.79 (1.03 to 3.12), respectively.
  
  
  CONCLUSIONS
  The presence of an ASD or a VSD was associated with NEC in this cohort of premature infants.
authors.affiliation: 1] Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA [2] Department of Pediatrics, Duke University Medical Center, Duke University, Durham, NC, USA.
authors.forename: J
authors.initials: J
authors.lastname: Bain
authors.affiliation: 1] Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA [2] Department of Pediatrics, Duke University Medical Center, Duke University, Durham, NC, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Benjamin
authors.affiliation: 1] Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA [2] Department of Pediatrics, Duke University Medical Center, Duke University, Durham, NC, USA.
authors.forename: C P
authors.initials: CP
authors.lastname: Hornik
authors.affiliation: Clemson University, Clemson, SC, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Benjamin
authors.affiliation: Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA.
authors.forename: R
authors.initials: R
authors.lastname: Clark
authors.affiliation: 1] Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA [2] Department of Pediatrics, Duke University Medical Center, Duke University, Durham, NC, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Smith
mesh_terms: D015897:Comorbidity; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology*; D005865:Gestational Age; D006344:Heart Septal Defects, Atrial / Q000453:epidemiology*; D006345:Heart Septal Defects, Ventricular / Q000453:epidemiology*; D006801:Humans; D019102:Infant, Very Low Birth Weight; D016017:Odds Ratio