Factors Influencing Outcomes in Neonatal Abdominal Surgery: Surgeons’ Perspectives

Neonatal abdominal surgery was often indicated by congenital conditions, presenting significant risks of morbidity and mortality. However, comprehensive surgical data and identification of complication-related risk factors still receive little attention. Purpose: Our objectives were to characterize neonatal patients undergoing abdominal surgery and to identify prognostic factors influencing complications and mortality in those patients. Methods: A retrospective study was conducted on newborn patients aged between 0-30 days undergoing index surgery at a university hospital from 2013 to 2021. Categorical data were compared between the without-complication group and the with-complication group using the Chi-square tests and Fisher-Exact tests. Continuous data were analyzed using Wilcoxon rank sum tests. A significance level of P < 0.05 was employed. Complications were defined as any events requiring intervention, either surgical or medical. Logistic regression was used to identify prognostic factors for complications and mortality. Results: There were 154 neonates undergoing 173 index procedures. Nineteen patients had more than one condition. The 5 most common conditions requiring abdominal surgery included abdominal wall defect (31%), colorectal diseases (16%), intestinal atresia (14%), necrotizing enterocolitis (8%), and meconium peritonitis (7%), respectively. The incidence of patients with at least one complication was 44.8%, and the mortality rate was 7.8%. By using logistic regression, factors affecting complications included birth weight110 mins (p=0.03). Significant influences on mortality were birth weight <1000g >(p=0.02), cardiovascular anomalies (p=0.02), CDH (p=0.001), and platelet count <100,000/µl (p=0.03). Conclusion: This study provides valuable insights into factors influencing outcomes in neonatal abdominal surgery. Birth weight110 mins were identified as significant contributors to complications. Birth weight