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World Journal of Pediatrics

, Volume 12, Issue 1, pp 55–59 | Cite as

Outcome in neonates with necrotizing enterocolitis and patent ductus arteriosus

  • Ulf Kessler
  • Franzisca Schulte
  • Dietmar Cholewa
  • Mathias Nelle
  • Stephan C. Schaefer
  • Peter M. Klimek
  • Steffen Berger
Original article

Abstract

Background

There is no agreement of the influence of patent ductus arteriosus (PDA) on outcomes in patients with necrotizing enterocolitis (NEC). In this study, we assessed the influence of PDA on NEC outcomes.

Methods

A retrospective study of 131 infants with established NEC was performed. Outcomes (death, disease severity, need for surgery, hospitalization duration), as well as multiple clinical parameters were compared between NEC patients with no congenital heart disease (n=102) and those with isolated PDA (n=29). Univariate, multivariate and stepwise logistic regression analyses were performed.

Results

Birth weight and gestational age were significantly lower in patients with PDA [median (95% CI): 1120 g (1009-1562 g), 28.4 wk (27.8-30.5 wk)] than in those without PDA [median (95% CI): 1580 g (1593-1905 g), 32.4 wk (31.8-33.5 wk); P<0.05]. The risk of NEC-attributable fatality was higher in NEC patients with PDA (35%) than in NEC patients without PDA (14%)[univariate odds ratio (OR)=3.3, 95% CI: 1.8-8.6, P<0.05; multivariate OR=2.4, 95% CI: 0.82-2.39, P=0.111]. Significant independent predictors for nonsurvival within the entire cohort were advanced disease severity stage III (OR=27.9, 95% CI: 7.4-105, P<0.001) and birth weight below 1100 g (OR=5.7, 95% CI: 1.7-19.4, P<0.01).

Conclusions

In patients with NEC, the presence of PDA is associated with an increased risk of death. However, when important differences between the two study groups are controlled, only birth weight and disease severity may independently predict mortality.

Key words

congenital heart disease necrotizing enterocolitis neonatal mortality patent ductus arteriosus 

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Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ulf Kessler
    • 1
    • 4
  • Franzisca Schulte
    • 1
  • Dietmar Cholewa
    • 1
  • Mathias Nelle
    • 2
  • Stephan C. Schaefer
    • 3
  • Peter M. Klimek
    • 1
  • Steffen Berger
    • 1
  1. 1.Department of Pediatric Surgery, InselspitalUniversity Hospital and University of BernBernSwitzerland
  2. 2.Division of Neonatology, Department of Pediatrics, InselspitalBern University Hospital and University of BernBernSwitzerland
  3. 3.Institute of Pathology, InselspitalUniversity of BernBernSwitzerland
  4. 4.Department of SurgeryHFR Fribourg-Cantonal HospitalBernSwitzerland

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