A retrospective study: Risk factors and clinical presentation of neonatal surgical conditions

Background: Neonatal surgical conditions are a significant cause of morbidity and mortality in neonates. This study analyzed the socio-demographic characteristics, risk factors, types, and clinical presentation of surgical conditions of neonates admitted for surgical interventions.

Objectives: To evaluate the clinical presentation of neonatal surgical conditions, assess maternal health and birth risk factors, and identify prevalent surgical diagnoses.

Methods: This was a retrospective review of medical records of neonates admitted with surgical conditions at Khartoum Teaching Hospital and Ibrahim Malik Teaching Hospital from January 2020 to August 2022. Data collected included socio-demographic information, maternal health history, birth characteristics, symptom duration, and diagnosis.

Results: 114 neonates' medical records were reviewed. The majority (66, 57.9%) presented within the first week of life, with a male-to-female ratio of 1.2:1. Most neonates (87, 76.3%) were born to non-consanguineous couples, and 108 (94.7%) had no family history of similar conditions. Maternal comorbidities were rare 2 (1.8%). Birth weight distribution showed that 94 (82.5%) were of average weight. Congenital surgical conditions constituted 113 (99.1%) of cases, most cases were gastrointestinal 59 (51.8%), followed by CNS cases 23 (20.2%), abdominal wall defects 12 (10.5%), urological defects 8 (7%), respiratory cases 1 (0.9%), and other miscellaneous cases 11 (9.6%). Anorectal malformations constituted the most common gastrointestinal condition, accounting for 16 cases (14%), followed by Hirschsprung disease 13 (11.4%), jejunal atresia 11 (9.6%), and malrotation 9 (7.8%). 

Conclusions: This study highlights the prevalence of congenital anomalies as the primary cause of neonatal surgical conditions, with gastrointestinal malformations being the most common. Early presentation within the first week of life and the absence of significant maternal or genetic risk factors were notable findings. Addressing the challenges of late diagnosis, inadequate prenatal screening, and resource limitations is essential for improving outcomes in neonatal surgical care.