Necrotising enterocolitis and mortality in very preterm babies with severe congenital heart disease
File(s)
Published online version
Author(s)
Nezafat Maldonado, Behrouz
van Blankenstein, Emily
Lanoue, Julia
Milan, Anna
Bellsham-Revell, Hannah
Type
Journal Article
Abstract
Background
Prematurity and congenital heart disease (CHD) are risk factors for neonatal morbidity, including necrotising enterocolitis (NEC), and mortality. We describe the rates of NEC and survival in very preterm babies with severe CHD (sCHD), requiring cardiac intervention before discharge.
Methods
Retrospective cohort study utilizing the National Neonatal Research Database that included babies born <32weeks’ gestation admitted to neonatal units in England and Wales, 2012–2020. Exposure: Babies born <32weeks’ gestation with sCHD, that require intervention before discharge (excluding patent arterial ducts). Outcomes: rates of sCHD, severe NEC (requiring surgery or death) and mortality (death before 37 weeks’ CGA or neonatal discharge, whichever occurred first).
Results
438/68,423 babies had a sCHD diagnosis (6.4 per 1000 admissions <32weeks). Compared to non-CHD infants, sCHD infants had a higher rate of severe NEC (7.1% (95% CI 5.0–9.9%) vs.3.7% (95% CI 3.6–3.8%), (p < 0.001)) and higher mortality before 37weeks’ corrected gestational age (CGA) (31%, (95% CI 26.8–35.4%) vs. 10% (95% CI, 9.7, 10.2%) (p < 0.001)). Adjusted models showed that very preterm sCHD babies were two times more likely to develop NEC and six times more likely to die before 37weeks’ CGA.
Conclusion
Very preterm babies with sCHD have higher rates of NEC and mortality before cardiac intervention.
Prematurity and congenital heart disease (CHD) are risk factors for neonatal morbidity, including necrotising enterocolitis (NEC), and mortality. We describe the rates of NEC and survival in very preterm babies with severe CHD (sCHD), requiring cardiac intervention before discharge.
Methods
Retrospective cohort study utilizing the National Neonatal Research Database that included babies born <32weeks’ gestation admitted to neonatal units in England and Wales, 2012–2020. Exposure: Babies born <32weeks’ gestation with sCHD, that require intervention before discharge (excluding patent arterial ducts). Outcomes: rates of sCHD, severe NEC (requiring surgery or death) and mortality (death before 37 weeks’ CGA or neonatal discharge, whichever occurred first).
Results
438/68,423 babies had a sCHD diagnosis (6.4 per 1000 admissions <32weeks). Compared to non-CHD infants, sCHD infants had a higher rate of severe NEC (7.1% (95% CI 5.0–9.9%) vs.3.7% (95% CI 3.6–3.8%), (p < 0.001)) and higher mortality before 37weeks’ corrected gestational age (CGA) (31%, (95% CI 26.8–35.4%) vs. 10% (95% CI, 9.7, 10.2%) (p < 0.001)). Adjusted models showed that very preterm sCHD babies were two times more likely to develop NEC and six times more likely to die before 37weeks’ CGA.
Conclusion
Very preterm babies with sCHD have higher rates of NEC and mortality before cardiac intervention.
Date Issued
2026-05-16
Date Acceptance
2026-03-07
Citation
Pediatric Research, 2026, 1 (1)
ISSN
0031-3998
Publisher
Springer Nature [academic journals on nature.com]
Journal / Book Title
Pediatric Research
Volume
1
Issue
1
Copyright Statement
© The Author(s) 2026 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Publication Status
Published
Date Publish Online
2026-05-16