Increased incidence of necrotizing enterocolitis in premature infants born to HIV-positive mothers

Objective: To examine if being born to an HIV-positive mother may increase the risk of necrotizing enterocolitis in premature infants. Design: Case-control study. Setting: Neonatal unit of a level 3 perinatal centre. Methods: Over a period of 8.5 years, all cases of necrotizing enterocolitis occurring in premature infants admitted to the neonatal unit were identified. For each case, two controls were retrospectively chosen that matched for postmenstrual age at birth, intrauterine growth and year of birth. Perinatal characteristics were studied in all infants. Main results: There were 79 cases of necrotizing enterocolitis, which were compared with 158 controls. Using multivariate analysis, multiple pregnancy [odds ratio (OR), 2.29; 95% confidence interval (Cl), 1.23-4.25; P = 0.009], abnormal umbilical artery velocity (OR, 2.21; 95% Cl, 1.08-4.54; P = 0.030), abnormal fetal heart rate (OR, 2.14; 95% Cl, 1.05-4.36; P = 0.036) and HIV-positive mother (OR, 6.63; 95% Cl, 1.26-34.8; P = 0.025) were significantly more frequent in fetuses who subsequently developed necrotizing enterocolitis. Conclusions: This preliminary report suggests an association, not previously reported, between maternal HIV-positive status and an increased risk of necrotizing enterocolitis in premature infants. Despite the limitations of this study, we suggest that premature newborn infants of HIV-positive mothers should be monitored very carefully for a possible increased risk of necrotizing enterocolitis. (c) 2005 Lippincott Williams & Wilkins.