Cardiogenic Necrotizing Enterocolitis in Infants with Congenital Heart Disease: A Systematic Review and Meta-analysis.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pediatric Cardiology Pub Date : 2024-10-29 DOI:10.1007/s00246-024-03686-4

Ivor B Asztalos, Stephanie N Hill, Dustin B Nash, Susan K Schachtner, Kelsey J Palm

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引用次数: 0

Abstract

Necrotizing enterocolitis (NEC) is a known cause of morbidity and mortality in infants with congenital heart disease (CHD), but reports about the burden of cardiogenic NEC frequently conflict. To synthesize the extant literature on the incidence, risk factors, and prognosis of NEC in patients with CHD. Medline, Cochrane, and EMBASE were searched from 1946 through 2023 for studies of NEC in infants 0-12 months of age with CHD. Risk of bias was assessed with validated tools for incidence and risk factors. Pooled estimates were meta-analyzed by risk of bias or synthesized without meta-analysis. Eighty-six studies with a total of 67,924 participants were included. The incidence of cardiogenic NEC was 7.1% (95% CI 4.7-10.5%) in term infants and 13.0% (10.2-16.5%) in low birthweight preterm infants. NEC required surgery in 0.8% (0.5-1.1%) of term and 2.7% (2.0-3.7%) of premature infants, respectively. Only gestational age and birth weight were consistently associated with risk of NEC. Restricting pooled estimates to studies of moderate or low risk of bias significantly reduced the number of studies included. Necrotizing enterocolitis is a common cause of morbidity in infants with CHD, but additional research is needed to determine which infants are at highest risk of developing NEC and would benefit most from a change in management. This systematic review and meta-analysis was conducted according to a prespecified protocol registered at the Prospective Register of Systematic Reviews (CRD42021282114).

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先天性心脏病婴儿的心源性坏死性小肠结肠炎：系统回顾与元分析》。

众所周知，坏死性小肠结肠炎（NEC）是先天性心脏病（CHD）婴儿发病和死亡的原因之一，但有关心源性 NEC 负担的报道经常出现冲突。综述有关先天性心脏病患者 NEC 发病率、风险因素和预后的现有文献。我们检索了 Medline、Cochrane 和 EMBASE 中从 1946 年到 2023 年有关 0-12 个月患有心脏病的婴儿 NEC 的研究。使用经过验证的工具对发病率和风险因素进行了偏倚风险评估。根据偏倚风险对汇总的估计值进行荟萃分析，或在不进行荟萃分析的情况下进行综合分析。共纳入 86 项研究，参与人数达 67,924 人。足月儿心源性 NEC 的发病率为 7.1%（95% CI 4.7-10.5%），低出生体重早产儿的发病率为 13.0%（10.2-16.5%）。需要进行手术的 NEC 早产儿和足月儿分别为 0.8%（0.5-1.1%）和 2.7%（2.0-3.7%）。只有胎龄和出生体重与发生 NEC 的风险持续相关。将汇总的估计值限制在中度或低度偏倚风险的研究中，大大减少了纳入研究的数量。坏死性小肠结肠炎是患有先天性心脏病的婴儿发病的常见原因，但还需要进行更多的研究，以确定哪些婴儿患坏死性小肠结肠炎的风险最高，哪些婴儿会从改变管理中获益最多。本系统综述和荟萃分析是根据在系统综述前瞻性注册中心（CRD42021282114）注册的预设方案进行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Cardiology 医学-小儿科

CiteScore

3.30

自引率

6.20%

发文量

258

审稿时长

12 months

期刊介绍： The editor of Pediatric Cardiology welcomes original manuscripts concerning all aspects of heart disease in infants, children, and adolescents, including embryology and anatomy, physiology and pharmacology, biochemistry, pathology, genetics, radiology, clinical aspects, investigative cardiology, electrophysiology and echocardiography, and cardiac surgery. Articles which may include original articles, review articles, letters to the editor etc., must be written in English and must be submitted solely to Pediatric Cardiology.