title: The association of congenital heart disease with necrotizing enterocolitis in preterm infants: a birth cohort study.
abstract: OBJECTIVE
  To test the hypothesis that congenital heart disease (CHD) in preterm infants with severe CHD (cyanotic or left-sided obstructive lesions, or congestive heart failure) is independently associated with necrotizing enterocolitis (NEC, stage II or greater).
  
  
  METHODS
  Single-institution retrospective birth cohort of preterm infants with gestational age 23(0/7) to 34(6/7) weeks delivered between 1 January 2002 and 31 December 2011, excluding infants who received comfort care. Patients were classified into severe CHD, mild CHD and control groups.
  
  
  RESULTS
  Among 4678 infants, 170 (3.6%) had CHD and 118 (2.5%) developed NEC. The risk for NEC increased with severe CHD (adjusted relative risk (RR)=3.72; 95% confidence interval (CI)=1.37 to 10.10) but not with mild CHD (RR=0.65; CI=0.27 to 1.55).
  
  
  CONCLUSIONS
  In this cohort, severe but not mild CHD was independently associated with increased risk for NEC. This finding, if confirmed by other studies, may help identify patients at risk for NEC.
authors.affiliation: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: C
authors.initials: C
authors.lastname: Motta
authors.affiliation: Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: W
authors.initials: W
authors.lastname: Scott
authors.affiliation: Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: L
authors.initials: L
authors.lastname: Mahony
authors.affiliation: Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Koch
authors.affiliation: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: M
authors.initials: M
authors.lastname: Wyckoff
authors.affiliation: Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Reisch
authors.affiliation: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Burchfield
authors.affiliation: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: L P
authors.initials: LP
authors.lastname: Brion
mesh_terms: D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015999:Multivariate Analysis; D016012:Poisson Distribution; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate