Stafford IA, et al. - The relationship between neonatal early-onset invasive Group B streptococcus (EO-GBS) and necrotizing enterocolitis (NEC) was determined. Outcomes demonstrated a strong correlation between neonatal EO- GBS disease and NEC. Newborns of GBS positive mothers showed more than a five-fold increase in the odds of developing NEC.

Methods

• Researchers collected data from 2008-2015 from pediatric records with ICD diagnosis codes consistent with all stages of NEC, with the exception of neonatal EO-GBS data (only available 2011–2015).

Results

• Inclusion criteria was met by 131 newborns; the mean gestational age (GA) and birthweight at delivery were 30.2 weeks and 1449 g.
• No association of maternal comorbidities with a more advanced stage of NEC was observed.
• However, male gender (OR 3.2, p < .001), lower mean 1 (OR = .89, p=.045) and 5 minute Apgar scores (OR = .84, p=.009) were significantly associated with higher NEC stage, after controlling for GA.
• No significant association of infectious morbidities including chorioamnionitis (OR = 1.5, p=.553) and intrapartum antibiotic administration (OR = 1.3, p=.524) with higher NEC stage was evident.
• Neither neonatal sepsis workup (OR = .27, p=.060) nor positive blood culture (OR = .97, p=.942) prior to NEC diagnosis were observed to be statistically significant.
• Type of feed prior to diagnosis (p=.530) was not significantly associated with NEC stage.
• However, expressed breast milk tended to be protective against higher stage of NEC (OR = .49, p=.055).
• In this study, type of feed included total parenteral nutrition, mother’s or donor expressed breast milk, trophic, full and high calorie feeds.
• From 2011–2015, 579 newborns were admitted.
• Of these, 13 (2%) were diagnosed with EO-GBS and 64 met diagnostic criteria for NEC.
• Significantly higher odds of NEC were evident among GBS positive newborns (OR = 5.37, p=.009).
• No significant differences regarding NEC stage were observed among patients with GBS positive vs GBS negative mothers (p=.732), nor was there a significant difference in GA (p=.161).