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. 2022 May 6:78:103711.
doi: 10.1016/j.amsu.2022.103711. eCollection 2022 Jun.

Observational study on necrotizing enterocolitis in neonates born to SARS-CoV-2-positive mothers

Dina Angelika  1 , Risa Etika  2 , Naomi Nathania Kusumawardani  3 , Setya Mithra  4 , I Dewa Gede Ugrasena  2
Affiliations

Observational study on necrotizing enterocolitis in neonates born to SARS-CoV-2-positive mothers

Dina Angelika et al. Ann Med Surg (Lond). .

Abstract

Background: The impact of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic on expectant mother and their babies extends to many aspects of life. Necrotizing enterocolitis (NEC) has been recognized as a life-threatening gastrointestinal inflammatory process in neonates that has high rates of morbidity and mortality.

Objective: To investigate factors associated with NEC in hospitalized neonates whose mothers were SARS-CoV-2-positive and their relationship to mortality.

Method: This observational study was conducted from May 2020 to March 2021. All neonates who were hospitalized, after confirming that the mother was SARS-CoV-2-positive, were included in this study. The confirmation of positive SARS-CoV-2 was determined according to the reverse transcription-polymerase chain reaction (PCR) assay. The neonatal SARS-CoV-2 test was performed on the first day of birth. NEC was established based on a suggestive clinical presentation and abnormal abdominal radiographs.

Results: Of the 125 neonates enrolled in this study, there were 5 neonates who developed NEC and only one survived. Significant associated factors with NEC included lower birth weight (p < 0.001), lower gestational age (p < 0.001), positive SARS-CoV-2 PCR results (OR = 15.333; 95% CI = 2.074-113.381, p = 0.007), asphyxia (OR = 13.143; 95% CI = 1.411-122.443, p = 0.024), and mortality (OR = 156.000; 95% CI = 13.157-1849.623; p < 0.001). Mortality was significantly associated with lower gestational age (p = 0.025), cesarean section delivery (p = 0.025), and asphyxia (p = 0.025).

Conclusion: Significant associated factors with NEC in neonates born to SARS-CoV-2-positive mothers included positive SARS-CoV-2 PCR results, asphyxia, lower gestational age, and lower birth weight. In addition to caesarean section delivery, these factors were related to mortality in neonates in such conditions.

Keywords: Enterocolitis; Mother; Necrotizing; Newborn; SARS-CoV-2-positive.

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Conflict of interest statement

Dina Angelika, Risa Etika, Naomi Nathania Kusumawardani, Setya Mithra, and I Dewa Gede Ugrasena declare that they have no conflict of interest.

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