Anatomical location of small bowel atresia independently predicts preterm delivery: a two-center study in Southern...

Small bowel atresia (SBA) presents with variable clinical features depending on anatomical location. We investigated the relationship between atresia location and preterm delivery.

We retrospectively reviewed 58 patients who underwent surgery for SBA at two institutions between April 2000 and March 2024. Patients were divided into preterm (<37 weeks, n=28) and term (≥37 weeks, n=30) groups. Clinical characteristics, prenatal findings, anatomical location, and surgical outcomes were compared. A logistic regression analysis identified independent predictors of preterm delivery.

Preterm infants showed lower birth weight (1988±731 g vs. 3062±395 g, p<0.001) and higher rates of prenatal diagnosis (85.7% vs. 60.0%, p=0.040), polyhydramnios (42.9% vs. 13.3%, p=0.018), and bowel dilatation (78.5% vs. 50.0%, p=0.031). The distance from the ligament of Treitz was shorter in preterm infants (31.6±31.5 cm vs. 103.6±39.9 cm, p<0.001). Jejunal atresia was more common in preterm infants (71.4% vs. 6.7%; p<0.001). A strong correlation was observed between birth weight and atresia distance (r=0.63, p<0.001). In a multivariable analysis, proximal atresia was an independent predictor of preterm delivery (adjusted OR 0.79 per 10 cm, 95% CI 0.65-0.96, p=0.018).

Proximal SBA was independently associated with preterm delivery. Prenatal identification may facilitate appropriate perinatal management and parental counseling.