The frequency of inguinal hernia in premature newborns (9-11%) is higher than in full-term (3-5%) and presents a significant risk of incarceration (30%). An incarcerated hernia increases the risk of gonadal ischemia (testicle and ovary), obstruction, and intestinal ischemia.
Symptomatic inguinal hernias can complicate the clinical course of newborns hospitalized in the intensive care unit for respiratory distress syndrome, sepsis, necrotizing enterocolitis, or other problems that need artificial respiratory support.
Correction of inguinal hernia should be carried out before the baby leaves the hospital to avoid complications. Premature newborns have a poorly developed breathing control center, they are more prone to diaphragm muscle fatigue, predisposing to potentially life-threatening respiratory complications, such as apnea and need for mechanical breathing support.
The post-conception age, which is the sum of the intrauterine and extrauterine age of the newborn, is referred to as the most important factor of postoperative complications. For that reason, premature newborns with an age after conception < 45 weeks should remain in the hospital for postoperative monitoring for at least 24 hours, after surgical correction of inguinal hernia. Babies with an age after conception > 60 weeks may be released with relative safety on the same day.