Impact of Raised CRP in Mortality and Morbidity among Neonatal Intestinal Obstruction Cases

Background: Neonatal intestinal obstruction is a grave reason for morbidity and mortality. C-reactive protein (CRP), an acute-phase reactant, may have prognostic implications in predicting the outcome in such patients. This research aimed to identify whether there was any relationship between admission CRP and clinical outcome in neonates presenting with intestinal obstruction. Materials and Methods: The retrospective observational study examined 80 neonates (0-28 days) with intestinal obstruction over a 12-month period. Admission CRP values were categorized as normal (<6 mg/L), mildly elevated (6-15 mg/L), moderately elevated (16-30 mg/L), and highly elevated (>30 mg/L). The primary outcomes were mortality and morbidity. Statistical analysis included frequency distributions and Chi-square tests with p<0.05 as the significance level. Results: Out of the study population (60% male), 31.25% were preterm neonates and 27.5% were of low birth weight. The intestinal obstruction was congenital in 56.25% and acquired in 43.75%. CRP values were normal in 31.25%, slightly raised in 18.75%, moderately raised in 20%, and extremely raised in 30% of the neonates. Increasing CRP values were associated with mortality (20% in normal versus 35% in highly elevated groups, p=0.02). Moreover, morbidity also rose with increased CRP (32% normals vs. 50% high raised groups, p=0.01). Combined mortality or morbidity was observed in 85% neonates with high raised CRP compared to 52% normal CRP. Conclusion: Elevated CRP, particularly when moderately or significantly elevated, is highly associated with increased mortality and morbidity in neonates with intestinal obstruction. Measurement of CRP upon admission can be a valuable predictive marker for risk stratification and clinical management in this high-risk population.