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Spontaneous intestinal perforation in premature infants: a national study

Journal of Perinatology volume 41, pages 1122–1128 (2021)Cite this article

Subjects

Abstract

Objectives

To assess the prevalence and outcomes of spontaneous intestinal perforation (SIP) in very low birth weight infants.

Study design

This cross-sectional study utilized the National Inpatient Sample dataset for the years 2002–2017. All premature infants with birth weight (BW) <1500 g and with gestational age (GA) ≤32 weeks were included. Analyses were repeated after stratifying the population into two BW sub-categories <1000 g and 1000–1499 g. Trend analysis was done using Cochran–Armitage test. Regression analysis was conducted to control for gestational age, race, and sex.

Result

A total of 658,001 infants were included. SIP (n = 10,443, 1.6%) was mostly (81.9%) in the category <1000 g with 89.9% ≤28 weeks of gestation. There was a significant trend for increased SIP over the years (p < 0.001). SIP was associated with increased mortality (aOR = 2.24, CI: 2.04–2.46, p < 0.001).

Conclusion

After controlling for gestational age and other confounders, SIP is associated with increased mortality in premature infants.

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Fig. 1: Prevalence and mortality of spontaneous intestinal perforation and necrotizing enterocolitis by gestational age.
Fig. 2: Race distribution of spontaneous intestinal perforation and necrotizing enterocolitis by gestational age.
Fig. 3: Trends for spontaneous intestinal perforation and necrotizing enterocolitis.

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Authors and Affiliations

  1. Department of Neonatology, Cleveland Clinic Children’s, Cleveland, OH, USA

    Marwa M. Elgendy, Farah Heis, Ibrahim Qattea & Hany Aly

  2. Department of Pediatrics, Michigan State University/Sparrow Health System, Lansing, MI, USA

    Hasan F. Othman

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  1. Marwa M. Elgendy
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  2. Hasan F. Othman
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  3. Farah Heis
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  5. Hany Aly
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Contributions

MME, FH, IQ, and HA conceptualized and designed the study, interpreted the statistical analyses, drafted the initial manuscript, reviewed and revised the manuscript coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. HFO conceptualized and designed the study, carried out the initial analyses, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Marwa M. Elgendy.

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Elgendy, M.M., Othman, H.F., Heis, F. et al. Spontaneous intestinal perforation in premature infants: a national study. J Perinatol 41, 1122–1128 (2021). https://doi.org/10.1038/s41372-021-00990-2

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