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American Academy of Pediatrics National Conference and Exhibition
October 30, 2013
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Full-term infants with late-onset NEC, CHD at greater mortality risk

ORLANDO, Fla. — Full-term infants with congenital heart disease who develop late-onset necrotizing enterocolitis have an increased mortality rate compared with infants with early-onset disease, according to data presented during the 2013 AAP National Conference and Exhibition.

Infants who develop necrotizing enterocolitis (NEC) after 7 days of age were more likely to have undergone a previous operation and have a chromosomal anomaly, which likely increased the rates of mortality, according to Scott S. Short, MD, from the division of pediatric surgery at Children’s Hospital Los Angeles.

Scott S. Short, MD 

Scott S. Short

Short and colleagues conducted a two-center retrospective review to characterize the full-term NEC population and to evaluate differences between infants with early-onset NEC (aged 7 days or less) compared with late-onset disease (aged more than 7 days).

Full-term infants, defined as gestational age of at least 37 weeks, diagnosed with NEC between 1990 and 2012 were included in the study. Patients were identified by abstracting ICD-9 codes 777.5 through 777.6 from hospital billing registries and charts were reviewed to verify diagnosis of NEC and gestational age.

A total of 39 patients were identified (24 boys, 15 girls) with Bell’s stage of 2 or greater at a median gestational age of 39 weeks. Univariate predictors of mortality included congenital heart disease (P=.04) and the need for UA catheter (P<.01); overall mortality was 18%.

Based on the study results, Short and colleagues said that they found significant differences between the two early- and late-onset groups, including increased risk of mortality in the late-onset group.

“When comparing children with early (≤ 7 days) vs. late (> 7 days) onset of disease we found significant differences between the two groups, including increased risk of mortality in the late onset group,” Short and colleagues wrote.

For more information:

Short SS. Abstract #21073. Presented at: 2013 AAP National Conference and Exhibition; Oct. 26-29, 2013; Orlando, Fla.

Disclosure: Short reports no relevant financial disclosures.