Evidence map›Paper›PMID 41398690›Full record

SynthesisItalian journal of pediatrics2025

SARS-CoV-2 infection during pregnancy and necrotizing enterocolitis: case report and review of the literature.

Gregorio Serra, Marco Pensabene, Deborah Bacile, Maria Rita Di Pace, Donatella Ferraro, Mario Giuffrè, Ettore Piro, Sergio Salerno, Ingrid Anne Mandy Schierz, Maria Sergio and 1 more

Abstract readCase ReportsSystematic Review
In one paragraph

Synthesis in Italian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Gregorio SerraNeonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Marco PensabenePaediatric Surgery Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy. marco.pensabene@policlinico.pa.it.
Deborah BacileNeonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Maria Rita Di PacePaediatric Surgery Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Donatella FerraroClinical Microbiology Laboratory, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Mario GiuffrèNeonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Ettore PiroNeonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Sergio SalernoPaediatric Radiology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Ingrid Anne Mandy SchierzNeonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Maria SergioPaediatric Surgery Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Giovanni CorselloNeonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNecrotizing enterocolitis (NEC) is a severe intestinal disease primarily affecting premature newborns, with high morbidity and mortality. Although typically linked to prematurity and low birth weight, recent reports have suggested a potential association between NEC and maternal SARS-CoV-2 infection during pregnancy. This study aims to explore this relationship through a systematic literature review and the presentation of a novel clinical case. CASE PRESENTATION: A female neonate born at 37 + 2 weeks of gestation to a mother with third-trimester SARS-CoV-2 infection presented with feeding intolerance, abdominal distension, and bloody stool at 8 days of life. Diagnostic evaluation confirmed necrotizing enterocolitis, necessitating multiple surgeries for bowel resection, stoma creation, and repair of perforations. Despite intensive multidisciplinary care, the patient developed severe complications, including short bowel syndrome and intestinal failure, leading to death at 18 months. SARS-CoV-2 IgG positivity in the neonate suggested transplacental antibody transfer after maternal infection, while most of the other possible risk factors were excluded.

conclusionsThe presented case highlights the potential role of maternal SARS-CoV-2 infection in necrotizing enterocolitis pathogenesis. Literature review identified 10 studies documenting similar associations. Cases ranged in severity, with outcomes influenced by gestational age, infection timing, and neonatal risk factors. The proposed mechanisms include virus-induced inflammation, placental dysfunction, and altered neonatal gut microbiota. Our findings emphasize the importance of considering maternal SARS-CoV-2 infection as a contributing factor in NEC, especially in term neonates without known predisposing conditions. Further research is crucial to elucidate the possible link between COVID-19 and NEC, and guide management of affected neonates. Preventive strategies, including vaccination and optimized prenatal care, are essential to mitigate risks.

Indexed as

COVID-19Enterocolitis, NecrotizingPregnancy Complications, InfectiousAdultFatal OutcomeFemaleHumansInfant, NewbornPregnancySARS-CoV-2COVID-19GestationNECNewbornsSARS-CoV-2 infection

Identifiers

PMID41398690
PMCPMC12706900

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.