Neonatal Abdominal Distension: A Spectrum of Causes and Clinical Outcomes in a Tertiary NICU

Background: Abdominal distension is a common and potentially serious presentation in neonatal intensive care units (NICUs). This study aimed to investigate the etiologies, management, and outcomes of neonates with abdominal distension in a tertiary referral center in southern Iran. Methods: This retrospective cross-sectional study included all neonates admitted with abdominal distension to Namazi Hospital, Shiraz, from September ۲۰۲۱ to September ۲۰۲۴. Data were obtained from hospital records using a structured checklist and analyzed with SPSS version ۲۶. The Mann–Whitney U test was used for continuous variables and the Chi-square test for categorical variables, with p < ۰.۰۵ considered significant. Results: A total of ۱۷۱ neonates were included, ۱۰۹ (۶۳.۷%) male and ۶۲ (۳۶.۳%) female, with a mean age at presentation of ۱۰.۵ ± ۱۲.۱ days, gestational age of ۳۵.۶ ± ۴.۵ weeks, and birth weight of ۲۷۷۵.۵ ± ۷۸۱.۶ g. Obstructive causes were found in ۸۴ (۴۹.۱%) cases and non-obstructive in ۸۷ (۵۰.۹%). The most frequent etiologies were unknown (۱۹.۹%), imperforate anus (۱۹.۹%), and Hirschsprung disease (۱۸.۱%). Congenital anomalies were present in ۳۵.۷%, mainly congenital heart disease (۸۱.۹%). Compared with non-obstructive cases, the obstructive group presented earlier (۵.۰ ± ۸.۳ vs. ۱۴.۰ ± ۱۳.۶ days, p < ۰.۰۰۱), had higher birth weight (۲۸۸۹.۶ ± ۷۱۱.۱ vs. ۲۵۹۷.۰ ± ۷۲۵.۱ g, p = ۰.۰۴۳), and longer hospital stay (۱۰.۹ ± ۱۰.۳ vs. ۷.۴ ± ۶.۷ days, p = ۰.۰۰۷). Overall mortality was ۱۲.۱%, with no significant group difference (p = ۰.۲۸). Conclusion: Neonatal abdominal distension was nearly equally due to obstructive and non-obstructive causes, with congenital malformations being major contributors. Early diagnosis, screening for anomalies, and timely intervention are essential to improve outcomes.

کلیدواژه ها:

Abdominal distension ، Infant ، Neonatal Intensive Care Unit ، Newborn ، Treatment outcome