Risk factors related to omphalocele and gastroschisis

Omphalocele and gastroschisis are recognized as congenital malformations with a high mortality. Only 60% of children with such malformations survive until the end of the first year of age. It has been suggested that omphalocele and gastroschisis are associated with other congenital malformations, concerning the bones, the heart and the kidney. The aim of the present study is to determine the risk factors in 12 omphalocele and four gastroschisis cases diagnosed and surveyed in the last four years (November 2003-November 2007) at the Emergency County Hospital of Constanta. In 10 of the 16 cases of the studied group, the subjects resulted from spontaneous premature births. None of the cases in the studied group received the maximum APGAR score, values varying between 6 and 9. The average birth weight in the studied group is 2100 g, with values between 950 g and 2900 g. Maternal age is between 15-21-year-old. Average maternal age in cases of second-degree gastroschisis is 6.5 years younger than the witness population and in case of first degree is 5.8 years younger. 87.5% of children's mothers in studied group are first time pregnant, first time gestant. The mother's socio-economic status may be a risk factor on the occurrence of omphalocele and gastroschisis. 81.25% of children's mother in the studied group have no own income and half are single (mono-parental families). None of the studied cases had a history of congenitally malformed siblings, but half of the cases in the studied group associate congenital malformations of gastro-intestinal tract, locomotor system, kidneys and/or heart. The abdominal wall defect existing in gastroschisis is accompanied by the delay of the intestinal loops differentiation. In all cases of gastroschisis in the studied group, the thin intestine caliber is higher or equal to the one of the thick intestine, the intestinal loops remained outside the abdominal cavity have an aspect characteristic to the fifth month of fetal life.