Pediatric surgery international · 2026
Neonatal gastric perforation: a systematic review and meta-analysis of clinical characteristics, risk factors, surgical management and outcomes.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Najar Fayaz Ahmad, Ganayee Mohamad Altaf, Nabi Ubayer
Аннотация
BACKGROUND: Neonatal gastric perforation (NGP) is a rare but life-threatening surgical emergency of the newborn. We systematically reviewed its clinical characteristics, risk factors, surgical management and outcomes.
METHODS: Five databases were searched from inception to 31 December 2025 for observational studies reporting at least five neonates (≤ 28 days) with confirmed gastric perforation. Two reviewers independently screened records, extracted data and appraised quality. Proportions were pooled using random-effects models; predictors of mortality were summarised as odds ratios (OR). The review followed PRISMA 2020 and was registered in the International Prospective Register of Systematic Reviews (PROSPERO).
RESULTS: Twenty studies (410 neonates) were included. Pooled prevalences were prematurity 58.3%, low birth weight 63.5% and male sex 59.0%; abdominal distension (90.5%) and pneumoperitoneum (80.9%) were the commonest features. Primary repair was performed in 78.4% of operated neonates. Pooled in-hospital mortality was 28.6% (95% CI 22.0-36.3%). Sepsis at presentation (OR 4.10) and delay to surgery beyond 24 h (OR 3.55) were the strongest predictors of death.
CONCLUSIONS: NGP mainly affects premature, low-birth-weight neonates, and still carries approximately 28% mortality. Early recognition, prompt treatment of sepsis and timely surgery offer the clearest route to improved survival.
PROSPERO ID: CRD420261436438.
METHODS: Five databases were searched from inception to 31 December 2025 for observational studies reporting at least five neonates (≤ 28 days) with confirmed gastric perforation. Two reviewers independently screened records, extracted data and appraised quality. Proportions were pooled using random-effects models; predictors of mortality were summarised as odds ratios (OR). The review followed PRISMA 2020 and was registered in the International Prospective Register of Systematic Reviews (PROSPERO).
RESULTS: Twenty studies (410 neonates) were included. Pooled prevalences were prematurity 58.3%, low birth weight 63.5% and male sex 59.0%; abdominal distension (90.5%) and pneumoperitoneum (80.9%) were the commonest features. Primary repair was performed in 78.4% of operated neonates. Pooled in-hospital mortality was 28.6% (95% CI 22.0-36.3%). Sepsis at presentation (OR 4.10) and delay to surgery beyond 24 h (OR 3.55) were the strongest predictors of death.
CONCLUSIONS: NGP mainly affects premature, low-birth-weight neonates, and still carries approximately 28% mortality. Early recognition, prompt treatment of sepsis and timely surgery offer the clearest route to improved survival.
PROSPERO ID: CRD420261436438.