Neonatal Intestinal Obstruction: Prenatal Factors and Postnatal Outcomes

Meyer Children's Hospital IRCCS60 enrolled

Overview

Neonatal intestinal obstruction is one of the most common surgical emergencies in newborns. In some cases, signs of possible intestinal obstruction can already be detected during pregnancy through prenatal ultrasound. However, not all prenatal ultrasound findings accurately predict whether a newborn will truly have an intestinal obstruction after birth. The purpose of this retrospective observational study is to evaluate which prenatal ultrasound findings are most strongly associated with confirmed intestinal obstruction after birth. In particular, the study aims to identify a specific cutoff value for fetal bowel dilation that best predicts postnatal intestinal obstruction. Other prenatal ultrasound features, such as excess amniotic fluid (polyhydramnios), ascites, echogenic bowel, and other abdominal findings, will also be analyzed. The study will include newborns with a prenatal suspicion of intestinal obstruction who were evaluated at Meyer Children's Hospital between January 2016 and December 2024. Researchers will review existing medical records and ultrasound data. No additional tests or interventions will be performed for study purposes. The results of this study may help improve prenatal counseling, optimize delivery planning in specialized centers, and support early postnatal management of newborns at risk for intestinal obstruction.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Intestinal Obstruction

Eligibility

Sex: ALLMin age: 0 DaysMax age: 28 Days

Medical Language ↔ Plain English

Inclusion Criteria: * Neonates from singleton pregnancies with prenatal ultrasound suspicion of intestinal obstructive pathology * Availability of complete postnatal follow-up data Exclusion Criteria: * Missing delivery data * Missing prenatal ultrasound data

Outcomes

Primary Outcomes

Diagnostic Accuracy of Prenatal Fetal Bowel Diameter for Predicting Postnatal Intestinal Obstruction

Determination of the optimal cutoff value (in millimeters) of fetal bowel diameter measured by prenatal ultrasound that predicts confirmed intestinal obstruction after birth. Diagnostic performance will be evaluated using receiver operating characteristic (ROC) curve analysis, including sensitivity, specificity, area under the curve (AUC), and Youden index.

Time frame: From birth up to 28 days of life

Secondary Outcomes

Incidence of Prenatal Ultrasound Findings in Neonates With and Without Confirmed Intestinal Obstruction

Percentage of neonates presenting specific prenatal ultrasound findings (polyhydramnios, ascites, echogenic bowel, abnormal peristalsis, intra-abdominal calcifications, gastric dilatation, abnormal bowel content echogenicity, and fetal anemia) in the group with confirmed postnatal intestinal obstruction compared to the group without obstruction. Each ultrasound finding will be recorded as present or absent (yes/no) based on prenatal ultrasound assessment.