Effect of maternal human immunodeficiency virus status on the outcome of neonates with necrotizing enterocolitis

Aim: 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). Patients and 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. Conclusion: Neonates with NEC born to HIV+ mothers have a higher mortality.

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