Neonatal gastric perforation: a systematic review and meta-analysis of clinical characteristics, risk factors, surgical management and outcomes

Neonatal gastric perforation (NGP) is a rare but life-threatening surgical emergency of the newborn. We systematically reviewed its clinical characteristics, risk factors, surgical management and outcomes.

Five databases were searched from inception to 31 December 2025 for observational studies reporting at least five neonates (≤ 28 days) with confirmed gastric perforation. Two reviewers independently screened records, extracted data and appraised quality. Proportions were pooled using random-effects models; predictors of mortality were summarised as odds ratios (OR). The review followed PRISMA 2020 and was registered in the International Prospective Register of Systematic Reviews (PROSPERO).