The Incidence and Outcomes of Neonatal Intestinal Obstruction at Princess Marina Hospital Botswana

Neonatal intestinal obstruction (NIO) is a surgical condition with good outcomes in well-resourced health facilities. In Botswana, there are no data on NIO. During the study, all NIO cases across the country were treated at Princess Marina Hospital (PMH), the nation's largest referral hospital. For NIO in Botswana.

to determine the incidence, spectrum, outcomes and factors associated with mortality.

A retrospective descriptive case series of neonates admitted between January 2010 and December 2012 to PMH with NIO. Data were collected from medical and surgical records. All cases under one month of age at admission were included. The incidence was calculated using national birth statistics and risk factors for mortality were explored using univariable and multivariable regression.

Seventy-nine NIO patients had a median age at admission of 3 days (IQR: 2-6), 49% were male, and median time from birth to surgery was 5 days (IQR: 3-6). The incidence of NIO was 5.96 per 10,000 live births. The most common diagnosis was jejunal obstruction (35%). In-hospital case fatality rate was 37%. In a multivariable model that included birth weight, time to surgery and maternal HIV status, only birth weight of >2500g was significantly associated with survival (OR=25.7, 95% CI 2.71-243.1; p<0.01).

In Botswana, the incidence of NIO is similar to that in other settings. Overall mortality is high and low birth weight confers risk for mortality. This study provides a platform for further research to study the trends of NIO and explore other factors that affect outcomes.