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

Pediatr Cardiol. 2021 Dec;42(8):1688-1699. doi: 10.1007/s00246-021-02691-1. Epub 2021 Sep 12.

Abstract

Infants with congenital heart disease (CHD) are at an increased risk of developing necrotising enterocolitis (NEC), a serious inflammatory intestinal condition classically associated with prematurity. CHD not only increases the risk of NEC in preterm infants but is one of the most commonly implicated risk factors in term infants. Existing knowledge on the topic is limited largely to retrospective studies. This review acts to consolidate existing knowledge on the topic in terms of disease incidence, pathophysiology, risk factors, outcomes and the complex relationship between NEC and enteral feeds. Potential preventative strategies, novel biomarkers for NEC in this population, and the role of the intestinal microbiome are all explored. Numerous challenges exist in the study of this complex multifactorial disease which arise from the heterogeneity of the affected population and its relative scarcity. Nevertheless, its high related morbidity and mortality warrant renewed interest in identifying those infants most at risk and implementing strategies to reduce the incidence of NEC in infants with CHD.

Keywords: Congenital heart disease; Ductal dependent; Microbiome; NEC; Necrotising enterocolitis; Neonate.

Publication types

  • Review

MeSH terms

  • Child
  • Enterocolitis, Necrotizing* / epidemiology
  • Enterocolitis, Necrotizing* / etiology
  • Heart Defects, Congenital* / complications
  • Heart Defects, Congenital* / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight
  • Retrospective Studies