WIP 47 - Necrotizing enterocolitis in preterm infants with congenital heart disease: risk factors and outcomes from a dedicated neonatal cardiac program

Publication Number: WIP 47.7666

Julia C. Vickery, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Angelica M. Vasquez, NewYork-Presbyterian Morgan Stanley Children's Hospital, Edgewater, NJ, United States; Diana Vargas, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Marianne Garland, Columbia University, New York, NY, United States; Nimrod Goldshtrom, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Background: Necrotizing enterocolitis (NEC) continues to impact high risk infants such as those born prematurely or with congenital heart disease (CHD). While prematurity and CHD are known risk factors, within the premature CHD population, there is inconclusive data on whether risk factors such as prostaglandin use, CHD lesion type, feeding practice, and surgical exposure are consistent added risk factors to developing NEC.

Objective: We aimed to describe NEC incidence among a preterm population within a dedicated neonatal cardiac intensive care unit (NICU) and evaluate risk factors within a preterm cohort with CHD for the development of NEC.

Design/Methods: This study has been approved by the Institutional Review Board (IRB) at Columbia University Irving Medical Center. This is a retrospective case-control study of infants born < 34 weeks gestational age (GA), with a diagnosis of CHD requiring surgery with cardiopulmonary bypass in the birth hospitalization. Patients were admitted to the infant cardiac unit at Morgan Stanley Children’s Hospital in New York from 2006 to 2022. NEC diagnoses were made using the modified Bell’s staging criteria and verified by two physician reviewers. Case-control matching in 1:3 ratio will be performed using propensity score matching on varied patient, hospital and surgical factors to establish study cohort.

Data collection for this study began after IRB approval in February, 2024. Preliminary univariate testing for this cohort is underway and data analysis is expected to be completed by January, 2025. Ongoing work in this cohort is collecting detailed nutrition data through chart review to evaluate how feeding practices such as use of human milk pre- and post-operatively, use of fortification or formula and use of donor human milk may be associated with risks and outcomes for NEC in this population. This could help decipher nutrition patterns that provide more protective strategies for growing preterm infants with CHD as they mature towards interventions.