Pressure Injuries of Intrauterine Etiology in Neonates: A Scoping Review

BACKGROUND: Neonatal pressure injuries (PIs) are typically considered postnatal events, however, case evidence shows that some lesions originate in utero and are already present at birth. Their recognition is clinically relevant because they may mimic other congenital dermatological conditions and require specific neonatal wound care strategies. Misclassification can delay appropriate care and distort quality metrics. A clear framework distinguishing prenatal from postnatal lesions is needed. METHODS: A JBI-guided scoping review was designed in order to identify and synthesize the available evidence on pressure injuries of intrauterine origin, focusing on etiology, clinical presentation, and wound care management. A three-step search strategy was adopted and the PRISMA 2020 flow diagram was used to document the study selection process. DISCUSSION: Five studies met the inclusion criteria (4 case reports and one case series), describing 7 neonates. Most cases involved preterm infants delivered by cesarean section, frequently associated with premature rupture of membranes. The main etiological factors were reduced or absent amniotic fluid and intrauterine compression, including one case related to intrauterine medical devices. According to the EPUAP/NPIAP classification, lesions ranged from Stage 1 to deep tissue injury. All cases were managed conservatively, with healing times ranging from 1 week to several months and favorable outcomes. IMPLICATIONS FOR RESEARCH AND PRACTICE: Increased clinical awareness and early recognition of intrauterine PIs are essential. Further research is required to establish standardized definitions, improve diagnostic accuracy, and develop neonatal-specific, evidence-based wound care protocols.