Initial surgery for spontaneous intestinal perforation in extremely low birth weight infants is not associated with mortality or in-hospital morbidities.

Creator(s)

Amy B. Hair
Kevin M. Sullivan
Irfan Ahmad
Isabella Zaniletti
Shannon N. Acker
Muralidhar H. Premkumar
Kristina Reber
Katie A. Huff
Sujir Pritha Nayak
Robert DiGeronimo
Jae Kim
Jessica Roberts
Troy A. Markel
Beverly Brozanski
J Sharma, Children's Mercy HospitalFollow
Anthony J. Piazza
Toby D. Yanowitz
Children’s Hospitals Neonatal Consortium Necrotizing Enterocolitis Focus Group

Document Type

Article

Publication Date

12-2024

Identifier

DOI: 10.1038/s41372-024-02037-8

Abstract

OBJECTIVE: Determine short-term outcomes following peritoneal drain (PD), laparotomy (LAP) after PD (PD-LAP), and LAP in extremely low birth weight (ELBW) infants with spontaneous intestinal perforation (SIP).

STUDY DESIGN: ELBW infants with SIP were identified using the Children's Hospitals Neonatal Database. Mortality and length of stay (LOS) were compared among groups.

RESULTS: Of 729 SIP infants from 6/2010-12/2016, 383(53%) received PD, 61(8%) PD-LAP, and 285(39%) LAP. PD infants had lower GA at birth, at SIP diagnosis and upon admission than PD-LAP or LAP; and higher sepsis rates than LAP. Bivariate analysis and Kaplan-Meier survival estimates suggested PD had increased mortality vs. PD-LAP and LAP (27%, 11.5%, and 15.8% respectively, p < 0.001). However, surgical approach was not significantly associated with mortality in multivariable analysis accounting for GA and illness severity. LOS did not differ by surgical approach.

CONCLUSIONS: In ELBW infants with SIP, mortality, and LOS are independent of the initial surgical approach.

Journal Title

Journal of perinatology : official journal of the California Perinatal Association

Volume

44

Issue

12

First Page

1746

Last Page

1754

MeSH Keywords

Humans; Infant, Newborn; Infant, Extremely Low Birth Weight; Intestinal Perforation; Male; Female; Length of Stay; Drainage; Retrospective Studies; Laparotomy; Hospital Mortality; Kaplan-Meier Estimate; Infant, Premature, Diseases; Spontaneous Perforation; Gestational Age; Infant; Multivariate Analysis

Keywords

Intestinal Perforation; Length of Stay; Drainage; Retrospective Studies; Laparotomy; Hospital Mortality; Kaplan-Meier Estimate; Premature Infant Diseases; Spontaneous Perforation; Gestational Age; Multivariate Analysis

Recommended Citation

Hair AB, Sullivan KM, Ahmad I, et al. Initial surgery for spontaneous intestinal perforation in extremely low birth weight infants is not associated with mortality or in-hospital morbidities. J Perinatol. 2024;44(12):1746-1754. doi:10.1038/s41372-024-02037-8