title: Maternal risk factors for neonatal necrotizing enterocolitis.
abstract: OBJECTIVE
  This study aimed to investigate the relationship between maternal hypertensive disease and other risk factors and the neonatal development of necrotizing enterocolitis (NEC).
  
  
  METHODS
  This was a retrospective case-control study of infants with NEC from 2008 to 2012. The primary exposure of interest was maternal hypertensive disease, which has been hypothesized to put infants at risk for NEC. Other variables collected included demographics, pregnancy complications, medications and neonatal hospital course. Data were abstracted from medical records.
  
  
  RESULTS
  Twenty-eight cases of singleton neonates with NEC and 81 matched controls were identified and analyzed. There was no significant difference in the primary outcome. Fetuses with an antenatal diagnosis of growth restriction were more likely to develop NEC (p = 0.008). Infants with NEC had lower median birth weight than infants without NEC (p = 0.009). Infants with NEC had more late-onset sepsis (p = 0.01) and mortality before discharge (p = 0.001).
  
  
  CONCLUSIONS
  The factors identified by this case-control study that increased the risk of neonatal NEC included intrauterine growth restriction and lower neonatal birth weight. The primary exposure, hypertensive disease, did not show a significantly increased risk of neonatal NEC; however, there was a nearly two-fold difference observed. Our study was underpowered to detect the observed difference.
authors.affiliation: a Department of Obstetrics and Gynecology and.|b Division of Maternal-Fetal Medicine , Beth Israel Deaconess Medical Center , Boston , MA , USA.|c Harvard Medical School , Boston , MA , USA , and.
authors.forename: Melissa I
authors.initials: MI
authors.lastname: March
authors.affiliation: c Harvard Medical School , Boston , MA , USA , and.|d Department of Neonatology , Beth Israel Deaconess Medical Center , Boston , MA.
authors.forename: Munish
authors.initials: M
authors.lastname: Gupta
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Modest
authors.affiliation: a Department of Obstetrics and Gynecology and.|c Harvard Medical School , Boston , MA , USA , and.
authors.forename: Lily
authors.initials: L
authors.lastname: Wu
authors.affiliation: a Department of Obstetrics and Gynecology and.|c Harvard Medical School , Boston , MA , USA , and.
authors.forename: Michele R
authors.initials: MR
authors.lastname: Hacker
authors.affiliation: c Harvard Medical School , Boston , MA , USA , and.|d Department of Neonatology , Beth Israel Deaconess Medical Center , Boston , MA.
authors.forename: Camilia R
authors.initials: CR
authors.lastname: Martin
authors.affiliation: a Department of Obstetrics and Gynecology and.|b Division of Maternal-Fetal Medicine , Beth Israel Deaconess Medical Center , Boston , MA , USA.|c Harvard Medical School , Boston , MA , USA , and.
authors.forename: Sarosh
authors.initials: S
authors.lastname: Rana
keywords: Growth restriction; hypertension; necrotizing enterocolitis; preeclampsia; prematurity