[Predictors of mortality in neonatal spontaneous gastric perforation: a multiple-center study].

Objective: To analyze clinical data and predictors of mortality in neonatal spontaneous gastric perforation (SGP).

Material and methods: A two-center retrospective cohort study included neonates diagnosed with SGP between 1999 and 2023. This cohort was divided into survivors and dead neonates to identify prognostic factors of mortality.

Results: There were 11 neonates (male-to-female ratio 8:3). Mean gestational age was 33±3.2 weeks. Nine (82%) ones were preterm infants. The mortality rate was 54.5% (6/11), mean age - 7.7 days (range 2-20). The most common signs were abdominal distension and respiratory distress. All patients had pneumoperitoneum upon admission. Concomitant gastrointestinal anomalies were necrotizing enterocolitis (3 patients), gastroschisis (1 patient), and tracheoesophageal fistula (1 patient). Neonatal respiratory distress syndrome (RDS) is a prognostic factor of fatal outcome in patients with SGP. RDS in patients with SGP increases the probability of death by 39 times (OR 39.0; 95% CI 1.3 - 1191; p=0.04).

Conclusion: RDS is a prognostic factor of mortality in neonates with SGP. Identification of modifiable prognostic factors of mortality in critical periods of life of neonates with SPG will facilitate effective strategies for prevention and treatment of this pathology.