SynthesisPediatric surgery international2026
Neonatal gastric perforation: a systematic review and meta-analysis of clinical characteristics, risk factors, surgical management and outcomes.
Synthesis in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
backgroundNeonatal 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.
methodsFive 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).
resultsTwenty 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.
conclusionsNGP 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.
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