Outcomes in neonatal gastroschisis: an institutional experience

We describe outcomes of 70 infants with gastroschisis admitted to our neonatal intensive care unit between 2001 and 2005. Demographic data and outcome measures including discharge or death, simple versus complex (intestinal atresia, perforation, bowel necrosis, or volvulus), length of stay, mechanical ventilation and total parenteral nutrition, commencement of enteral feeds and age at reaching full feeds, and number of episodes of bacteremia were evaluated. In our study, 72% of the patients (n = 58) were simple cases, 28% were complex, and 44% had a positive blood culture. Median length of stay was 43 and 116 days for simple and complex cases, respectively. Median age at commencement of enteral feeds was 19 and 44 days for simple and complex cases, respectively. Six (14%) infants with simple and 8 (50%) with complex gastroschisis required an assisted feeding device (gastrostomy) tube before discharge. We concluded that the type of gastroschisis (simple versus complex) is an important determinant of outcome, including time to start and get to full feeds, duration of parenteral nutrition, length of stay, and survival. Although it is not always possible to determine whether the defect is simple or complex by antenatal scans, this information will be valuable to families with infants with gastroschisis and should be made available as soon as possible.