Distinctive clinical features of spontaneous pneumoperitoneum in neonates: A retrospective analysis

Table 1 Demographic findings

Variables	Group A, n = 13	Group B, n = 24	P value
Sex (male/female)	12/1	17/7	0.224
GA, wk	29.5 ± 5.3 (23-39)	31.7 ± 5.2 (23-39)	0.216
Preterm/full term	10/3 (76.9%)	16/8 (66.7%)	0.515
Birth weight, g	1479.2 ± 1071.2 (450-3670)	1888.2 ± 986.5 (670-3450)	0.189
Delivery (NSVD/CS)	1/12	10/14	0.057
Postnatal age at diagnosis, d	18.8 ± 29.9 (0-111)	12.1 ± 18.5 (1~ 79)	0.499
Apgar at 1 min	4.0 ± 2.5 (0-8)	4.3 ± 1.5 (0-8)	0.936
Apgar at 5 min	5.8 ± 2.0 (1-9)	6.5 ± 1.5 (0-9)	0.825

Values are presented as mean ± standard deviation or patient number. GA: Gestational age; NSVD: Normal spontaneous vaginal delivery; CS: Cesarean section.

Table 2 Preceding clinical history before diagnosing a pneumoperitoneum

Variables	Group A, n = 13	Group B, n = 24	P value	Odds ratio, 95%CI
MV at birth (yes/no)	12/1	17/7	0.216	4.333
HFOV (yes/no)	5/13	3/24	0.100	4.375
PPHN (yes/no)	7/6	2/22	0.004	12.833
RDS (yes/no)	11/2	15/9	0.262	3.3
Pneumothorax (yes/no)	6/7	1/23	0.004	19.7
CPR (yes/no)	3/10	2/22	0.321	3.3
Vasopressor infusion (yes/no)	11/2	12/12	0.074	5.5
MV duration, d	17.1 ± 30.2 (1-111)	12.4 ± 21.7 (2-79)	0.067	-

Values are presented as patient number or mean ± standard deviation. CI: Confidence intervals; MV: Mechanical ventilation; HFOV: High-frequency oscillation ventilation; PPHN: Persistent pulmonary hypertension; RDS: Respiratory distress syndrome; CPR: Cardiopulmonary resuscitation.

Table 3 Laboratory findings at diagnosis and outcomes

Variables	Group A, n = 13	Group B, n = 24	P value
Blood sugar, mg%	152.1 ± 58.2 (69-235)	148.3 ± 51.4 (85-294)	0.790
CRP, IU/L	1.28 ± 1.60 (0.01-4.88)	2.24 ± 4.03 (0.03-17.94)	0.649
WBC, 103/μL	14641.5 ± 7008.6 (3810-25470)	14568.8 ± 9349.4 (4410-37360)	0.561
Segmented neutrophil, %	57.5 ± 17.4 (20.3-87.0)	62.1 ± 12.8 (34.1-81.4)	0.479
PLT, 103/μL	156.1 ± 115.9 (6.0-371.0)	272.9 ± 143.8 (83.0-565.0)	0.015
Thrombocytopenia	8 / 13	5 / 24	0.013
pH	7.26 ± 0.15 (6.95-7.43)	7.27 ± 0.17 (6.92-7.48)	0.696
PaO2, mmHg	55.4 ± 19.2 (18.0-86.8)	100.9 ± 58.3 (46.3-227.2)	0.025
Overall mortality, %	76.9 (10/13)	16.6 (4/24)	0.001

Values are presented as mean ± standard deviation or patient number. CRP: C-reactive protein; WBC: White blood cell; PLT: Platelet.

Table 4 Clinical characteristics and analysis of factor affecting mortality in group A, n = 13

Variables	No of cases (%)	P value	Odd ratio (95%CI)
Management
Non-operative	5 (38.5)
Operation	8 (61.5)
Mortality, overall	10/13 (76.9)
Mortality in
Non-operative	5/5 (100)
Operative	5/8 (62.5)	0.231	0.625 (0.365-1.069)
Pneumothorax (+)	6/6 (100)
Pneumothorax (-)	4/7 (57.1)	0.067	1.750 (0.921-3.324)
PPHN (+)	6/7 (85.7)
PPHN (-)	4/6 (66.7)	0.416	3.0 (0.199-45.244)
RDS (+)	9/11 (81.8)
RDS (-)	1/2 (50.0)	0.326	4.5 (0.190-106.8)
HFOV (+)	4/5 (80.0)
HFOV (-)	6/8 (75.0)	0.912	1.333 (0.088-20.108)
Vasopressor (+)	9/11 (81.8)
Vasopressor (-)	1/2 (50.0)	0.326	4.5 (0.190-106.823)
CPR (+)	3/3 (100)
CPR (-)	7/10 (70.0)	0.279	1.429 (0.952-2.143)
Thrombocytopenia (+)	7/8 (87.5)
Thrombocytopenia (-)	3/5 (60.0)	0.51	4.667 (0.197-73.384)
Full-term	1/3 (33.3)
Preterm	9/10 (90.0)	0.041	18.0 (0.758-427.291)

PPHN: Persistent pulmonary hypertension; RDS: Respiratory distress syndrome; CPR: Cardiopulmonary resuscitation.

Table 5 Clinical characteristics of Group B, n = 24

Variable	Cases, n (%)
Associated gastrointestinal conditions
Gastric perforation	7 (29.2)
NEC	7 (29.2)
SIP	2 (8.3)
HD	4 (16.6)
Intestinal atresia	1 (4.2)
EA /c TEF	2 (8.3)
Malrotation	1 (4.2)
Mortality, overall	4 (16.6)

NEC: Necrotizing enterocolitis; SIP: Single intestinal perforation; HD: Hirschsprung disease; EA /c TEF: Esophageal atresia with distal tracheoesophageal fistula.