A regional study of underlying congenital diseases in term neonates with necrotizing enterocolitis

Aim of the study: The aetiology of necrotizing enterocolitis (NEC) remains poorly understood in infants of all gestation, particularly when it occurs at term. We hypothesize that NEC in term infants is rare but often associat ed with underlying congenital illnesses, Method: Records of all term infant s hospitalized with radiologically or surgically proven NEC in the 10 terti ary centres of two geographical regions of Australia during a 6.5-y period were reviewed. Regional birth data were obtained and a special care nursery survey was conducted, Results:: Twenty-nine infants had proven NEC giving a population incidence of 0.05 per 1000 live births. Nineteen (66%) of them had underlying congenital diseases. Five (17%) infants had endocrine disor ders, which included panhypopituitarism, hypothyroidism, hypoparathyroidism and congenital adrenal hyperplasia. Ten infants had congenital heart disea se, eight being cyanotic. Six of them developed NEC prior to any invasive c ardiac procedures. Seven of the other nine infants without any congenital d iseases had perinatal risk factors associated with NEC. The severity of ill ness was not different amongst the three groups. All infants, except two, s urvived. Conclusion: NEC in term infants is commonly secondary to or preceded by und erlying congenital diseases. A considerable proportion of NEC cases had co- existing endocrine illnesses.