Calcified necrotizing funisitis and its association with adverse neonatal outcomes: a case-control study

Necrotizing funisitis (NF) is a rare but severe type of umbilical inflammation. Whether NF can affect the outcomes of newborns is still controversal. The aim of this article is to determine the association of calcified necrotizing funisitis with adverse neonatal outcomes. This retrospective study included newborns who had undergone pathological examination between July 2020 and July 2024. Twenty-one neonates who were delivered at Jinan Maternity and Child Health Hospital with pathological results of calcified NF were retrospectively selected as the study group. Concurrently, 42 neonates admitted during the same period without a pathological finding of calcified NF were chosen as the control group. These control subjects were matched to the study group at a ratio of 1:2 according to gestational age. The outcome indicators of the neonates in both groups were comparable. All infants in both groups were preterm (gestational age < 37 weeks), with the NF group and non-NF group having a gestational age of 30+ 1±2+ 4 weeks. Compared with the control group, the observation group exhibited statistically significant differences in several maternal and neonatal outcomes. Specifically, the observation group had a higher rate of spontaneous vaginal delivery (P = 0.023), prolonged rupture of membranes (P < 0.001), and increased neonatal levels of white blood cells (P < 0.001), C-reactive protein (P < 0.001), and neutrophil proportion (P = 0.002). Conversely, the incidence of respiratory distress syndrome (P = 0.031), retinopathy of prematurity (P = 0.018), and duration of invasive ventilation use (P = 0.032) were significantly lower in the observation group, with all differences being statistically significant (P < 0.05). Ureaplasma urealyticum infection refers to the transmission of the organism from the mother to the neonate prior to or during delivery. Among the 21 patients in the case group, 14 (66.70%) were identified as positive for UU infection, whereas 4 (9.50%) in the control group tested positive. Such differences were statistically significant (P < 0.001). In neonates with placental pathology showing NF, there are significant increases in white blood cell count, C-reactive protein levels, and neutrophil proportion. However, these neonates exhibit a shorter duration of invasive mechanical ventilation, along with reduced incidences of respiratory distress syndrome and retinopathy of prematurity. Ureaplasma urealyticum infection has been identified as a risk factor for calcified neonatal fever.