What is the role of diminished blood flow in the pathogenesis of necrotizing enterocolitis (NEC) in infants?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Epidemiologically, some have noted that infants exposed to intrauterine environments marked by compromised placental blood flow (ie, maternal hypertension, preeclampsia, cocaine exposure) have an increased incidence of NEC. Similarly, infants with postnatally diminished systemic blood flow, as is found in patients with patent ductus arteriosus or congenital heart disease (both considered risk factors for NEC), also have an increased incidence. Infants with patent ductus arteriosus are at particularly high risk for developing NEC if pharmacologic closure is attempted.

A retrospective analysis compared outcomes of NEC in patients with congenital heart disease with outcomes of NEC in patients without congenital heart disease; the study demonstrated improved outcomes in patients with heart disease. This somewhat counterintuitive finding further emphasizes the multifactorial pathophysiology underlying NEC. [10]

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