Effect of maternal human immunodeficiency virus status on the outcome of neonates with necrotizing enterocolitis.
OBJECTIVE
The aim of the study was to assess the impact of human immunodeficiency virus (HIV) exposure on survival and extent of disease in necrotizing enterocolitis (NEC).


METHODS
All patients with NEC requiring surgery between June 1998 and June 2008 were analyzed. Three groups were identified: those born to HIV-positive (HIV+) mothers, those born to HIV-negative (HIV-) mothers, and those with an unknown HIV status. Primary outcome measure was survival to discharge. Secondary outcome measure was extent of disease.


RESULTS
One hundred nine infants (mean gestational age, 31 weeks; birth weight, 1413 g) underwent surgery for NEC. Gestational age, birth weight, and day of presentation were similar in all 3 groups, showing no statistical difference. The HIV+ group consisted of 22 infants, of which 13 (59%) died and 2 (9%) had panintestinal necrosis. The HIV- group consisted of 48 infants, of which 11 (23%) died, with 3(6%) having panintestinal necrosis. The remaining group of HIV (unknown) consisted of 38 infants, of which 14 (37%) died, with 2 (5%) having panintestinal necrosis. The latter group was not included in the analysis; but comparing the HIV+ and HIV- groups, there was a statistically higher chance of death (odds ratio = 4.8, P = .05). There was no difference statistically in the extent of disease.


CONCLUSIONS
Neonates with NEC born to HIV+ mothers have a higher mortality.
Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town 7701, South Africa. jonathan.karpelowsky@uct.ac.za
Jonathan Saul
JS
Karpelowsky
Stefanie
S
van Mil
Alp
A
Numanoglu
Ernesto
E
Leva
Alastair J W
AJ
Millar
D001724:Birth Weight; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000635:transmission; D018023:HIV Seronegativity / Q000276:immunology*; D006679:HIV Seropositivity / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical; D007422:Intestines / Q000473:pathology; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology*; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology; D016019:Survival Analysis