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The strong correlation between neonatal early-onset Group B Streptococcal disease and necrotizing enterocolitis
- Source :
- European journal of obstetrics, gynecology, and reproductive biology. 223
- Publication Year :
- 2017
-
Abstract
- Necrotizing enterocolitis (NEC) is a leading cause of newborn gastrointestinal emergencies, affecting 1-3 per 1000 live births. Although NEC has been linked to a microbial etiology, associations with maternal intrapartum and resultant newborn early-onset invasive Group B streptococcus (EO-GBS) have been weakly defined.The study aim was to determine the relationship between EO-GBS and NEC.Data from 2008 to 2015 were collected from pediatric records with ICD diagnosis codes consistent with all stages of NEC, with the exception of neonatal EO-GBS data (only available 2011-2015).For the 131 newborns meeting inclusion criteria, the mean gestational age (GA) and birthweight at delivery was 30.2 weeks and 1449 g. Maternal comorbidities were not associated with a more advanced stage of NEC, however male gender (OR 3.2, p .001), lower mean 1 (OR = 0.89, p = .045) and 5 min Apgar scores (OR = 0.84, p = .009) were significantly associated with higher NEC stage, after controlling for GA. Infectious morbidities including chorioamnionitis (OR = 1.5, p = .553) and intrapartum antibiotic administration (OR = 1.3, p = .524) were not significantly associated with higher NEC stage. Neither neonatal sepsis workup (OR = 0.27, p = .060) nor positive blood culture (OR = 0.97, p = .942) prior to NEC diagnosis were statistically significant. Type of feed prior to diagnosis (p = .530) was not significantly associated with NEC stage, however, expressed breast milk tended to be protective against higher stage of NEC (OR = 0.49, p = .055). Type of feed included total parenteral nutrition, mother's or donor expressed breast milk, trophic, full and high calorie feeds. Of the 579 newborns admitted from 2011 to 2015, 13 (2%) were diagnosed with EO-GBS and 64 met diagnostic criteria for NEC. GBS positive newborns had significantly higher odds of NEC (OR = 5.37, p = .009). NEC stage was not significantly different for patients with GBS positive vs. GBS negative mothers (p = .732), nor was there a significant difference in GA (p = .161).Our study is the first to describe a strong correlation between neonatal EO- GBS disease and NEC, with more than a five-fold increase in the odds of developing NEC in newborns of GBS positive mothers.To investigate a possible relationship between EO-GBS disease and the neonatal diagnosis of NEC. Secondary analysis will determine if maternal antepartum and intrapartum factors along with neonatal variables contribute to a more advanced stage of NEC by retrospective chart review of patient data collected at Children's Hospital: New Orleans.
- Subjects :
- Male
medicine.medical_specialty
Streptococcal disease
Gestational Age
Disease
Group B
Streptococcus agalactiae
Correlation
03 medical and health sciences
0302 clinical medicine
Sex Factors
Enterocolitis, Necrotizing
Pregnancy
Risk Factors
Streptococcal Infections
Medicine
Birth Weight
Humans
030212 general & internal medicine
Pregnancy Complications, Infectious
Early onset
business.industry
Obstetrics
Infant, Newborn
Obstetrics and Gynecology
Gestational age
medicine.disease
digestive system diseases
Infectious Disease Transmission, Vertical
Reproductive Medicine
Necrotizing enterocolitis
Apgar Score
Female
Diagnosis code
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18727654
- Volume :
- 223
- Database :
- OpenAIRE
- Journal :
- European journal of obstetrics, gynecology, and reproductive biology
- Accession number :
- edsair.doi.dedup.....a5f27002d6056bf905b780c649c0f473