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

I Martynov,U H Thome,A Franke,M Lacher,T K Rausch,C Härtel,W Göpel,B W Ackermann,A R Franz,D Viemann

doi:10.1038/s41598-021-93195-8

Abstract

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.

Highlights

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)
Preterm infants with blood group AB were at higher risk for surgical NEC/FIP compared to the non-AB-groups
In a multivariable logistic regression model which included covariates such as sex, gestational age, birth weight, multiple birth, medical and surgical Patent ductus arteriosus (PDA) treatments, we could observe a significantly higher risk of blood group AB for NEC/FIP when compared to non-AB-blood groups (Fig. 1)

Summary

Introduction

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). 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)[1, 2]. Blood group antigens are on the surface of red blood cells and occur in other tissues, including the intestinal surface They can be secreted into the lumen of the gut (and breast milk)—for ABO, for example, if the person carries another specific genetic variant in the gene FUT2 and is a so-called “secretor”—where these sugars serve as nutrients for intestinal microbes. ABO antibodies contribute to the innate immune system and attack some bacteria or viruses that carry ABO a ntigens[28]

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Conclusion