Predictors of Morbidity and Mortality of Neonatal Intestinal Obstruction.

Abstract

Neonatal intestinal obstruction (NIO) is a critical surgical emergency with high morbidity and mortality, particularly in resource-limited settings. This study aims to evaluate the predictors, treatment modalities, and outcomes of NIO in neonates admitted to a tertiary care hospital in Bangladesh. This cross-sectional observational study was conducted at the Department of Pediatric Surgery, Mymensingh Medical College Hospital, Bangladesh, from July 2017 to October 2018. Data were collected from 60 neonates diagnosed with NIO through detailed clinical evaluations, laboratory investigations and imaging studies. Treatment modalities included surgical interventions and conservative management, with outcomes analyzed using descriptive and inferential statistics. The majority of neonates (71.67%) were aged between 2-5 days, with a male predominance (66.67%). Anorectal malformation (45%) and Hirschsprung's disease (26.67%) were the most common causes of NIO. Surgical interventions were predominant, with pelvic colostomy (26.67%) and anoplasty (18.33%) being the most frequently performed procedures. Morbidity was observed in 71.67% of cases, while mortality occurred in 23.33%. Low birth weight (p<0.05), delayed presentation (p<0.05), elevated C-reactive protein (CRP) levels (p<0.05), and sepsis (p<0.05) were significantly associated with mortality. Early treatment (within 72 hours) showed a trend toward better survival, though not statistically significant (p>0.05). The study highlights low birth weight, delayed presentation, sepsis and elevated CRP levels as key predictors of adverse outcomes in neonates with NIO. Timely diagnosis, early intervention, and improved perioperative care are essential to reduce morbidity and mortality. Regional healthcare improvements are crucial for optimizing neonatal outcomes in resource-limited settings.