Blood group AB increases risk for surgical necrotizing enterocolitis and focal intestinal perforation in preterm infants with very low birth weight

Sci Rep. 2021 Jul 2;11(1):13777. doi: 10.1038/s41598-021-93195-8.


Necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP) are two of the most common emergencies of the gastrointestinal tract in preterm infants with very low birth weight (VLBW, birth weight < 1500 g). Identification of risk factors among these children is crucial for earlier diagnosis and prompt intervention. In this study, we investigated a relationship between ABO blood groups and the risk for surgical NEC/FIP. We genotyped the ABO locus (rs8176746 and rs8176719) in VLBW infants enrolled in a prospective, population-based cohort study of the German Neonatal Network (GNN). Of the 10,257 VLBW infants, 441 (4.3%) had surgical NEC/FIP. In univariate analyses, the blood group AB was more prevalent in VLBW infants with surgical NEC/FIP compared to non-AB blood groups (OR 1.51, 95% CI 1.07-2.13, p = 0.017; absolute risk difference 2.01%, 95% CI 0.06-3.96%). The association between blood group AB and surgical NEC/FIP was observed in a multivariable logistic regression model (OR of 1.58, 95% CI 1.10-2.26, p = 0.013) as well. In summary, our study suggests that the risk of surgical NEC and FIP is higher in patients with blood group AB and lower in those having non-AB blood groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ABO Blood-Group System / blood*
  • Child, Preschool
  • Enterocolitis, Necrotizing / blood
  • Enterocolitis, Necrotizing / epidemiology*
  • Enterocolitis, Necrotizing / pathology
  • Enterocolitis, Necrotizing / surgery
  • Female
  • Fetal Diseases / blood
  • Fetal Diseases / pathology
  • Fetal Diseases / surgery
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases / blood
  • Infant, Newborn, Diseases / epidemiology*
  • Infant, Newborn, Diseases / pathology
  • Infant, Newborn, Diseases / surgery
  • Infant, Premature / blood
  • Infant, Premature, Diseases / epidemiology*
  • Infant, Premature, Diseases / pathology
  • Infant, Premature, Diseases / surgery
  • Infant, Very Low Birth Weight
  • Intestinal Perforation / blood
  • Intestinal Perforation / epidemiology*
  • Intestinal Perforation / pathology
  • Intestinal Perforation / surgery
  • Male
  • Risk Factors


  • ABO Blood-Group System