Maternal hypertensive disorders are an independent risk factor for the development of necrotizing enterocolitis in very low birth weight infants

Fetal Diagn Ther. Nov-Dec 2003;18(6):404-7. doi: 10.1159/000073132.


Objective: The purpose of this study was to compare complications and outcome of preterm neonates weighing < or =1,500 g who developed necrotizing enterocolitis (NEC) to neonates without NEC.

Study design: During January, 1995 to December, 1998, 211 live preterm neonates were born with birth weight < or =1,500 g. A cross sectional prospective study was designed and two groups were defined: 17 neonates who developed NEC and 194 without NEC. Multiple logistic regression analysis was performed to determine independent risk factors for the development of NEC.

Results: The prevalence of NEC was 8% (17/211). The following complications were found to be significantly higher among mothers of neonates with NEC: mild pre-eclampsia (11.8 vs. 2.6%, p=0.04); severe pre-eclampsia (35.5 vs. 12.9%, p=0.01); chronic hypertension (29.4 vs. 5.7%, p<0.001) and low birth weight (968 +/- 233 vs. 1,123 +/- 257 g, p=0.02). In contrast, mean maternal age, mean gestational age at delivery and parity were not significantly different between the groups. A multivariate analysis including the following factors: maternal hypertensive disorders, pregestational diabetes mellitus, birth weight and gestational age at delivery, found only maternal hypertensive disorders to be independent risk factors for NEC (OR=5.21, 95% CI 1.64-16.58).

Conclusions: Maternal hypertension is an independent risk factor for the development of NEC in preterm neonates weighing <1,500 g. Thus, maternal vascular disorders may play an important role in the pathophysiology of NEC.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Chi-Square Distribution
  • Confidence Intervals
  • Cross-Sectional Studies
  • Enterocolitis, Necrotizing / epidemiology*
  • Enterocolitis, Necrotizing / etiology
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Pre-Eclampsia / complications
  • Pre-Eclampsia / epidemiology*
  • Pregnancy
  • Prospective Studies
  • Risk Factors