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Updated: Aug 23, 2025

A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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Mortality and neurodevelopmental outcomes of infants with spontaneous intestinal perforation: a systematic review and

Ju Li Ang1,2, Chandra Prakash Rath3,2, Herr Tan1,2

  • 1Neonatology, Perth Children's Hospital, Nedlands, Western Australia, Australia.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|November 3, 2022
PubMed

Insights

Spontaneous intestinal perforation (SIP) in very preterm infants is linked to increased mortality and severe disability. Further research is needed due to limited adjusted data.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Developmental Pediatrics

Background:

  • Limited data exists on mortality and neurodevelopmental outcomes for very preterm infants (<32 weeks) experiencing spontaneous intestinal perforation (SIP).
  • This study aims to investigate the association between SIP and these critical outcomes in extremely premature infants.

Approach:

  • A comprehensive literature search was conducted across multiple databases (Medline, EMBASE, Cochrane Library, EMCARE, MedNar) up to September 2021.
  • Meta-analysis of 18 cohort studies (13,606 infants) compared outcomes for infants with SIP versus those without SIP or necrotizing enterocolitis (NEC).
  • Neurodevelopmental outcomes at corrected age ≥1 year were extracted, and data were pooled using random-effects models, with evidence levels assessed by GRADE.

Key Points:

  • Unadjusted analysis indicated SIP significantly increased odds of mortality, cerebral palsy, composite death/disability, visual, and hearing impairment.
  • Adjusted analyses revealed significant associations between SIP and increased mortality (aOR 2.27), severe disability (aOR 2.06), and composite death or disability (aOR 2.18).
  • The overall level of evidence for these associations was rated as 'low' or 'very low' due to limited adjusted data.

Conclusions:

  • Spontaneous intestinal perforation in very preterm infants is associated with significantly higher odds of mortality and severe disability.
  • The findings highlight the serious implications of SIP for extremely premature infants' survival and long-term development.
  • Further research with more comprehensive adjusted data is warranted to fully elucidate the impact of SIP.
Abstract

Keywords:
infant developmentintensive care units, neonatalneonatology

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