History Of Maternal Infection Research Articles

The Relationship between Prenatal Risk Factors and The Incident of Sensorineural Deafness in Children at Polyclinic ENT- Head and Neck Zainoel Abidin Hospital Banda Aceh *,

Background: Sensorineural deafness is one of congenital disorders that caused by prenatal, natal, and postnatal factors. Sensorineural deafness is a public health problem in the world due to its high prevalence and highly negative impact on child development. Objective: To determine the relation between prenatal risk factors (family history of hearing loss, ototoxic drugs consumption, history of infection, history of Diabetes Mellitus, history of gestational hypertension) with sensorineural hearing loss in children at ENT- Head and Neck Polyclinic Dr. Zainoel Abidin Hospital. Methods: This study was analytic retrospective with cross sectional design. The sampling technique used was simple random sampling. The total samples are 47 children at the ENT-Head and Neck Polyclinic of RSUDZA who has been examined with OAE, BERA and ASSR from January 2020 to December 2021 and diagnosed with sensorineural hearing loss. Data were analyzed using SPSS which bivariate analysis using Chi- square and Fisher’s exact. Results: 47 children who had been diagnosed with sensorineural hearing loss included in the inclusion criteria. The mean age of children in this study was 3.44 years with male predominance of 55.3%. The most severe degree of hearing loss was found with the percentage of weight (93.6%) in right ear and (89.4%) in left ear. A history of maternal infection during pregnancy was the most common risk factor found in this study with profound hearing loss in both ears with p value = 0.05. Conclusion: No relation between prenatal risk factors and sensorineural hearing loss in children.

Associations between early-life and in utero infections and cytomegalovirus-positive acute lymphoblastic leukemia in children.

Childhood infections and cytomegalovirus (CMV) are associated with pediatric acute lymphoblastic leukemia (ALL). CMV dysregulates the host immune system and alters the immune response to subsequent antigenic exposures. We suspect that this immune dysregulation contributes to increased numbers of symptomatic infections in childhood allowing for expansion of pre-leukemic clones. We explored the association between childhood infections, maternal infections during pregnancy and CMV-positive ALL. Using a droplet digital PCR assay, we screened diagnostic ALL bone marrow samples from the California Childhood Leukemia Study (1995-2015) for the presence of CMV DNA identifying CMV-positive and CMV-negative cases. We performed a case-only analysis (n=524) comparing the number and types of childhood infections and maternal infections during pregnancy between CMV-positive and CMV-negative ALL cases using logistic regression. With increasing numbers of infections in the first 12 months of life, children were more likely to classify to the highest tertile of CMV DNA in the bone marrow at diagnosis (OR: 1.04, 95% CI: 1.01-1.08). Specifically, those reporting cough or flu in the first 12 months were more likely to be CMV-positive at ALL diagnosis (OR: 2.15, 95% CI: 1.06-4.37 and OR: 2.06, 95% CI: 1.17-3.63 respectively). Furthermore, those with a history of maternal infection during pregnancy were more likely to be CMV-positive (OR: 2.12, 95% CI: 1.24-3.62). We hypothesize that children with underlying immune dysregulation develop more symptomatic infections in childhood and ultimately CMV-positive ALL; this underlying immune dysregulation may be due to early immune system alterations via CMV exposure (in utero or early infancy) proposing a potential link between CMV and ALL etiology.

Is neonatal phototherapy associated with a greater risk of childhood cancers?

BackgroundNeonatal phototherapy (NNPT) has long been used as an effective and relatively safe method of treating neonatal hyperbilirubinemia. Considering the subsequent evidence of long-term impacts of NNPT such as malignancies, this study was conducted to evaluate the relationship between NNPT and childhood cancers.MethodsThis case-control study assessed 116 children up to 4 years old with every kind of cancer referred to the Oncology department of Afzalipour hospital, Kerman, Iran, from 2011 to 18. Moreover, 116 pediatric patients without cancer hospitalized at the same Center were included after sex and age matching as the control group. The history of phototherapy and its duration were evaluated in these two groups.ResultsWe found no association between the NNPT and malignancies in children. However, high intensive phototherapy was higher historically among affected cancerous patients than in non-cancerous cases without any statistically significant difference (25% vs 19%; P = 0.26). Maternal educational level and history of maternal infection during pregnancy, which initially appeared to be two factors associated with malignancy in single variable regression analyses, were not significant based on the adjusted models.ConclusionsThe results did not show a positive correlation between NNPT and childhood cancers, which may partly be due to the relatively small sample size of the study. However, some other evidence is worrisome enough that NNPT should not be considered risk-free. Additional multi-centric studies should be undertaken to specify that phototherapy is really safe.

Evidence for the Association Between STIs and Preterm Birth

Source: Gao R, Liu B, Yang W, et al. Association of maternal sexually transmitted infections with risk of preterm birth in the United States. JAMA Netw Open. 2021;4(11):e2133413. doi:10.1001/jamanetworkopen.2021.33413Investigators from multiple institutions conducted a retrospective study to assess the association between maternal sexually transmitted infections (STI) during pregnancy and premature birth. For the study, they reviewed data on birth certificates of children born by singleton birth between 2016 and 2019 in all 50 states and the District of Columbia. Data abstracted from birth certificates included demographic information, maternal pregnancy history, and estimated gestational age at birth. Also included on the birth certificates was a history of maternal infection with chlamydia, gonorrhea, and/or syphilis at the time of the diagnosis of pregnancy or during pregnancy. The primary study outcome was premature birth, defined as gestational age <37 weeks. Secondary outcomes included extremely premature birth (<28 weeks), very preterm birth (28-31 weeks), and moderately preterm birth (32-36 weeks). The association between maternal STI and these outcomes were assessed with logistic and multinomial regression, after adjustment for multiple confounders. Models that included any of the assessed STIs, and specific STIs were conducted. In addition, analyses stratified by maternal age or race/ethnicity were performed.Data on 14,373,023 singleton births were included in the analyses. The mean age of the mothers of these infants was 29 ± 5.8 years. A total 267,260 (1.9%) mothers had chlamydia, 43,147 (0.3%) had gonorrhea, and 16,321 (0.1%) had syphilis. Among the study newborns, 1,146,800 (8.0%) were born prematurely. In the multivariate model, any maternal STI was associated with an increased risk of premature birth (OR, 1.06; 95% CI, 1.05, 1.07); infection with chlamydia (OR, 1.03; 95% CI, 1.02, 1.04), gonorrhea (OR, 1.11; 95% CI, 1.08, 1.15), and syphilis (OR, 1.17; 95% CI, 1.11, 1.22) were each individually associated with an increased risk of premature birth. Maternal STI was associated with an increased risk of very premature birth (OR, 1.07; 95% CI, 1.03, 1.12), and moderately preterm birth (OR, 1.06; 95% CI, 1.05, 1.08), but not extremely premature birth (OR, 1.00; 95% CI, 0.95, 1.05). There was a small but statistically significant (P <0.001) increase in the risk of premature birth associated with maternal STI among women ≥35 years old (OR, 1.09), and those 25-34 years old (OR, 1.08), compared to those <25 years old (OR, 1.06). There was a statistically significant increased risk of premature birth associated with maternal STI among women who were white (OR, 1.10; 95% CI, 1.08, 1.13), Black (1.04; 95% CI, 1.02, 1.06) and Hispanic (OR, 1.06; 95% CI, 1.03, 1.09), but not Asian (OR, 1.01; 95% CI, 0.90, 1.13).The authors conclude that maternal infection with chlamydia, gonorrhea, or syphilis is associated with an increased risk of premature birth.Dr Von Kohorn has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.The holy grail of neonatal-perinatal medicine is the prevention of adverse newborn outcomes, and, ultimately, the prevention of preterm birth. Intrauterine infection is thought to be a leading cause of preterm birth, although the precise contribution of specific STIs to preterm birth is unclear.1 The current study, a high-quality observational analysis of more than 14 million women with singleton pregnancies in the US, provides some of the best evidence to date that STIs—specifically chlamydia, gonorrhea, and syphilis—are associated with preterm birth. Still, the nature of the study leaves key questions unanswered.The authors of the accompanying editorial comments that some epidemiologists caution against considering interpreting near-even odds, such as those in the current study, as valid when the sample size is extremely large.2 Furthermore, observational studies, no matter how large, are subject to bias and cannot determine causation.3 Thus, it remains possible that pregnant women with STIs in this study, or in general, are systematically prone to preterm birth for reasons other than the STIs themselves. Perhaps most importantly, the current researchers did not seek to elucidate whether prevention or treatment of STIs is effective in preventing preterm birth. Recent observational data suggest that treatment of STIs in pregnancy is not effective in preventing preterm birth.4 The editorial authors state that they know of no randomized controlled trials that answer this question.2 A randomized trial of STI prevention to decrease preterm birth is intriguing. It is unclear how a randomized trial could be designed for treatment of STIs, since treatment is the standard of care in pregnancy.The best evidence to date indicates that STIs are associated with preterm birth. It remains unclear whether treatment of STIs is an effective intervention to prevent preterm birth.

Correlation between Maternal Infection and Infant Cholestasis

Introduction: Infant cholestasis has been associated to viral infection. Cytomegalovirus in the pathogenesis of neonatal hepatitis has been already known and it is one of the possible etiological of biliary atresia. The aim of this study was to outline the correlation between maternal infection and infant cholestasis (aged 0-1 year old) in Department of Pediatrics Dr. Soetomo General Hospital, Surabaya. Methods: A case-control study of pregnant women who gave birth in Dr. Soetomo General Hospital from June 2016 to June 2017. The data were taken from medical records. The cases were defined as pregnant women with babies who had cholestasis, and the control was pregnant women who gave birth to a baby without cholestasis within the age of 0-1 year old. Sample cases in this study were drawn from the total population, with the inclusion criteria babies who had cholestasis, and exclusion criteria that include complications of pregnancy and a history of infant’s parent with genetic disorders. The control variable studied was maternal infection history and sex. Samples were taken by purposive control. The data were obtained then summarized and analyzed by univariate and bivariate, using the chi-square table analysis. Results: The number of cases that met the inclusion criteria were 68 patients, and the amount of control taken was 110 patients. The total number of patients studied was 178 patients. Univariate analysis found the cholestasis was more common in mother with infection during pregnancy (73.53% from the total of  cholestasis). Bivariate analyzes found relationship between pregnancy infection and cholestasis (p = &lt;0.001, or = 20.726). Conclusion:The maternal infection is significantly associated with cholestasis in infants. 

Review of Clinical Studies Targeting Inflammatory Pathways for Individuals With Autism.

Immune dysfunction and abnormal immune response may be associated with certain mechanisms underlying autism spectrum disorder (ASD). The early evidence for this link was based on the increased incidence of ASD in children with a history of maternal infection during pregnancy. Observational studies show increased prevalence of immune-related disorders—ranging from atopy, food allergy, viral infections, asthma, primary immunodeficiency, to autoimmune disorders—in individuals with ASD and their families. Evidence of neuroglial activation and focal brain inflammation in individuals with ASD implies that the central nervous system immunity may also be atypical in some individuals with ASD. Also, both peripheral and central inflammatory responses are suggested to be associated with ASD-related behavioral symptoms. Atypical immune responses may be evident in specific ASD subgroups, such as those with significant gastrointestinal symptoms. The present review aimed to evaluate current literature of potential interventions that target inflammatory pathways for individuals with ASD and to summarize whether these interventions were associated with improvement in autism symptoms and adaptation. We found that the current literature on the efficacy of anti-inflammatory interventions in ASD is still limited and large-scale randomized controlled trials are needed to provide robust evidence. We concluded that the role of immune-mediated mechanisms in the emergence of ASD or related challenges may be specific to subsets of individuals (e.g. those with concurrent immunological disorders, developmental regression, or high irritability). These subsets of individuals of ASD might be more likely to benefit from interventions that target immune-mediated mechanisms and with whom next-stage immune-mediated clinical trials could be conducted.

Autism Associated With Anti-NMDAR Encephalitis: Glutamate-Related Therapy.

The purpose of this review is to correlate autism with autoimmune dysfunction in the absence of an explanation for the etiology of autism spectrum disorder. The anti-N-methyl-D-aspartate receptor (anti-NMDAR) autoantibody is a typical synaptic protein that can bind to synaptic NMDA glutamate receptors, leading to dysfunctional glutamate neurotransmission in the brain that manifests as psychiatric symptoms (psychosis, hallucinations, and personality changes). Detection of autoantibodies, cytokines, decreased lymphocytes, serum immunoglobulin level imbalance, T-cell mediated immune profile, maternal infection history, and children’s infection history can all be vital biological markers of autoimmune autism. Diagnosing autoimmune encephalitis sooner can increase the effectiveness of curative treatments—such as immune therapy or immune modulatory therapy—that may prevent the long-term consequence of being misdiagnosed with autism spectrum disorder. Glutamate therapy primarily normalizes glutamate neurotransmission and can be a new add-on intervention alongside antipsychotics for treating autoimmune autism.

Epidemiological Profile of High-Risk Pregnancies in Lubumbashi: Case of the Provincial Hospital Janson Sendwe

Maternal and child health is an important part in the health development plans in many countries. This descriptive study aimed to investigate the epidemiology of risk pregnancies managed at the provincial hospital Janson Sendwe. It was conducted from March 17 to July 15, 2015 to all pregnant women for childbirth consultant beyond 28 weeks of gestation and having at least one risk factor identified during antenatal care or a posteriori childbirth. On 535 women included in the study, we recorded 1667 risk factors in an average of 3.2 risk factors per woman. The three main risk factors were met by order of importance: the history of maternal infection (18.5%), the history of caesarean section (13.6%) and unexplained fetal or neonatal death antecedent (12.4%). The antecedent of uterine malformation (0.1%), the history of macrosomia (0.5%) and uterine height decreased (2.1%) were the least represented. It thus appears necessary to carefully monitor these women to avoid the occurrence of maternal mortality.

Perinatal factors associated with the development of cow's milk protein allergy

The prevalence of cow's milk protein allergy (CMPA) has increased in recent years, and is associated with antimicrobial use during the perinatal period, prematurity, the type of childbirth, and the decrease in breastfeeding. The aim of this study was to analyze whether there is any association between these factors and the development of CMPA. Material and methodsA retrospective, comparative, cross-sectional, observational study was conducted by reviewing the case records of 101 children diagnosed with CMPA and seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 2012 and August 2013. The following variables were included: age, sex, weeks of gestation, history of maternal infection and antimicrobial use during the pregnancy, type of delivery, and feeding with human milk, and its duration. Likewise, the case records of 90 children were reviewed as a control group on not having CMPA or any other allergy. The chi-square test was used for proportions, and the Mann-Whitney U test was used for comparing means in the statistical analysis. ResultsThe factors associated with CMPA were the use of antimicrobials during gestation and breastfeeding duration in months. Both factors were statistically significant (P<.001). No association was found between CMPA and gestational age or type of delivery. ConclusionsThe statistically significant associated factors were breastfeeding duration and the use of antimicrobials during the gestational stage. These results underline the necessity for prospective studies.

The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection.

BackgroundIn the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.MethodsA description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.ResultsTwenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2–6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275–522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36–38, median birth weight: 2550 grams, IQR 2270 – 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 – 42), with no adverse events reported. No child acquired HIV-1 infection.ConclusionsDespite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

A 7-Week-Old Boy with Violaceous Patches and Skin Nodules

A 7-week-old boy presented to the pediatric dermatology clinic for evaluation of diffuse blue lesions on the skin. The mother first noticed a bluish lesion on the left thigh at 6 to 7 weeks of age. The child quickly developed several similar lesions and deeper nodules on the head, arms, and trunk. He had a history of ankyloglossia and subsequent uncomplicated repair, as well as a sister with neonatal anemia. He was otherwise well and thriving. Review of systems was unremarkable. His birth involved an uncomplicated delivery, with negative maternal serology. There was no history of maternal infection or recent exposure to infection. Physical exam revealed a well-appearing, non-dysmorphic, vigorous infant. Skin exam was notable for numerous dusky erythematous and violaceous-blue patches and nodules on the anterior scalp, bilateral arms, legs, face, and trunk - including the diaper area. Lesions ranged in size from 1 to 3 cm. The nodules were firm and non-tender. The remainder of his physical examination was normal without abnormal lymphadenopathy or hepatosplenomegaly noted. No mucosal lesions were noted. A biopsy was performed on a thigh lesion.

Giant transient pustular melanosis in an infant

An otherwise healthy male newborn infant was admitted directly from the delivery room because of multiple pustular lesions spread throughout the body just after his birth. He was born at...

Maternal nicotine dependence and prenatal smoking and their association with mental disorders among offspring from the community

diagnosed with autistic spectrum disorders (ICD-9CM=299.0X) were initially identified (boys: 3470; girls: 714), followed by the selection of 1:4 control children via matching criteria of offspring's birth year/month, gender, maternal age at delivery, and residential region (boys: 13,878; girls: 2856). History of maternal infection through three trimesters of pregnancy was obtained through outpatient care utilization records, and type of infection was further classified by organ/disease (e.g., respiratory, urinary, and genital tracts) and microorganism (i.e., virus and bacteria). Conditional logistic models were employed to evaluate the risk estimates, with simultaneous adjustment for maternal characteristics (e.g., history of mental disorders, autoimmune diseases, and complication at/after delivery), children's factors (e.g., mental retardation), and antibiotics use due to infection. Results: Pooled analyses demonstrated that genital infection (adjusted odds ratio [aOR]: 1.22; 95% Confidence Interval [95% CI]: 1.03–1.45) and bacterial infection (aOR: 1.19; 95% CI: 1.03–1.37) in the third trimester were associated with increased risk of autism. Further comparison on autistic children by gender suggested that girls were more likely to have mental retardation (15.41% vs. 11.01%, Pb.001), neonatal infections (5.88% vs. 3.54%, Pb .01), and complications at/after delivery (6.02% vs. 4.29%, Pb .5) than boys. Influenza infection during the third trimester (aOR: 3.25; 95% CI: 1.33–7.95) may increase the risk of autism for girls, whereas for boys, perinatal genital infection seems more salient (aOR: 1.21; 95% CI: 1.01–1.47). Conclusions: Our study suggested that perinatal infection, especially in the third trimester, may be associated with increased occurrence of autistic spectrum disorders and such association may also vary by infectious agents and system organs involved. Future research on the role of infection, the mechanism underlying the development of autism, and possible sex variation in such pathways should be addressed.

883 Incidence of Leishmaniasis in a District General Hospital

AimTo study the incidence of Leishmaniasis in children under 5 years in a District General Hospital in the UK.MethodThe microbiology records over 5-years (2005–2010) were reviewed. Inclusion criteria were age...

Infection by cytomegalovirus in patients with neonatal cholestasis.

Neonatal cholestasis syndrome with an intra or extrahepatic origin has been associated to viral infections. The participation of the cytomegalovirus in the etiopathogenesis of neonatal hepatitis has been already known for some time, but only recently there have been indications that this virus may be one of the possible etiological factors for extrahepatic biliary atresia. To assess the prevalence of infection by cytomegalovirus in patients with intrahepatic cholestasis and extrahepatic cholestasis. To compare the clinical characteristics of the intrahepatic cholestasis and extrahepatic cholestasis groups with the cytomegalovirus serological results. Patients and Methods - This study consisted of 76 patients with neonatal cholestasis who were admitted between January 1980 and January 1999 when they underwent a cytomegalovirus serologic study using the ELISA method. A case note was kept on each patient with the following data: age of patient at admission, serologic result for cytomegalovirus, history of maternal infection, prematurity, fetal distress, birth weight, ponderal gain, choluria and fecal acholia. The final anatomic diagnosis of cholestasis was based on the results of an abdominal ultrasonography, a liver biopsy and its evolution. The patients were then divided into two groups: group I - intrahepatic cholestasis and group II - extrahepatic cholestasis. Each of these groups were then divided into two subgroups: subgroup A - positive serology (IgM) for cytomegalovirus and subgroup B - negative serology (IgM) for cytomegalovirus. The frequency of positive serology (IgM) for cytomegalovirus was 29.4% in children with intrahepatic cholestasis and 28.5% in children with extrahepatic cholestasis. In comparison with group IIB, group IIA presented a higher rate of maternal infection history. The patients in group IIA demonstrated a delayed access to the service in comparison with group IA. The groups did not demonstrate any significant differences regarding the onset age of jaundice, choluria and fecal acholia, birth weight and ponderal gain. The positive (IgM) seroprevalence for cytomegalovirus in children with intrahepatic cholestasis and extrahepatic cholestasis is high. The history of maternal infection was more common in extrahepatic cholestasis patients with positive serology for cytomegalovirus. There was a delay in the referral of these patients which resulted in a late diagnosis and surgical treatment.

Neonatal herpes simplex virus infection in the British Isles

Summary. This study was set up to estimate the incidence of neonatal herpes simplex virus (HSV) infection in the British Isles, and to document the outcome of neonatal infection. Paediatricians reported cases of neonatal HSV through the active reporting scheme of the British Paediatric Association Surveillance Unit. Over a 5half year period (1986-91) 76 infants with neonatal HSV infection were reported, an incidence of recognised infection in the British Isles of 1.65/100000 livebirths. Twenty-five infants had HSV-1 infection, 24 HSV-2 and in 27 virus type was unknown. Twenty-seven had disseminated infection, 23 herpes encephalitis and 26 localised infection. Nineteen infants (25%) died in the neonatal period, and a further 25 (33%) have subsequently died or have long-term sequelae. At least half of the infants had been discharged home before symptoms became apparent. For 21 women there was evidence of a maternal genital herpes infection at some time, but this was reported or diagnosed retrospectively after neonatal HSV was suspected in 19 cases, and ante-natally in only two. Neonatal HSV is rare in the British Isles and routine antenatal screening for genital herpes infection during pregnancy is not justified. A high proportion of infected infants present with non-specific signs and symptoms and without mucocutaneous involvement; furthermore, there is rarely a history of maternal infection. As early diagnosis and prompt treatment is essential, there must be a high level of awareness of the serious nature of neonatal HSV infection.

Prenatal diagnosis of fetal cYtomegalovirus infection

Twelve fetuses were evaluated with a combination of ultrasonography, amniocentesis, and blood sampling for possible cytomegalovirus infection. In seven the mother had a documented primary cytomegalovirus infection. All seven women had normal ultrasonographic findings and one fetus was found to be infected. In the other five cases fetal cytomegalovirus infection was diagnosed in association with abnormal utlrasonographic findings. There was no history of maternal infection in the latter group. All positive and negative diagnoses were confirmed and none of the six infected fetuses survived. In this series, the most reliable parameters of infection were the isolation of the virus from amniotic fluid and elevations of total immunoglobulin M and -y-glutamyl transpeptidase in fetal blood. In the majority of infected fetuses cytomegalovirus-specific immunoglobulin M was not detected in blood. Prenatal diagnosis of fetal cytomegalovirus infection is possible with a combination of amniocentesis and fetal blood sampling.

Mycoplasma hominis. A cause of neonatal meningitis.

Two cases of Mycoplasma hominis meningitis in the newborn are described. These infants demonstrate the need to consider M. hominis as a cause of neonatal meningitis, especially if the Gram stain is negative, conventional cultures yield no growth, and there is a history of maternal infection. CSF cultures on appropriate medium can quickly confirm the diagnosis.

Necrotizing enterocolitis in premature infants

A syndrome consisting of vomiting, abdominal distention, gastrointestinal bleeding,and shock has been observed in premature infants. The disorder is usually fatal, and on postmortem examination, ulcerations are seen in the gastrointestinal tract, particularly the terminal ileum. History of maternal infection during delivery is significant. Anteand postmortem cultures in infants with enterocolitis reveal predominance of gramnegative organisms. Criteria for diagnosis are presented.