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Clinical presentation of children with gastroschisis and small for gestational age

I-Lun Chen1, Shin-Yi Lee, Mei-Chen Ou-Yang

  • 1Department of Pediatrics, Division of Neonatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Pediatrics and Neonatology
|August 13, 2011
PubMed

Insights

Infants with gastroschisis (GS) who are small for gestational age (SGA) experience poorer outcomes, including longer hospital stays and more complications. This highlights the need for careful monitoring and long-term follow-up for these infants.

Area of Science:

  • Neonatal surgery
  • Pediatric surgery
  • Fetal medicine

Background:

  • Gastroschisis (GS) is a congenital condition involving abdominal wall defects and organ evisceration.
  • Fetal growth restriction is common in GS cases, though other anomalies are rare.
  • Outcomes in GS infants based on gestational age and birth weight are not well-differentiated.

Purpose of the Study:

  • To compare outcomes of gastroschisis (GS) between infants small for gestational age (SGA) and appropriate for gestational age (AGA).
  • To evaluate differences between term and late preterm infants with GS.
  • To analyze primary outcomes (hospital stay, TPN duration, surgical complications) and secondary outcomes (body weight percentile at 6 months).

Main Methods:

  • Retrospective review of neonates with GS born at or after 34 weeks gestation.
  • SGA defined as birth weight below the 10th percentile for gestational age.
  • Immediate surgical repair was performed for all included infants.

Main Results:

  • Small for gestational age (SGA) infants had significantly longer hospital stays, more surgical complications, and lower body weight percentiles at 6 months compared to appropriate for gestational age (AGA) infants.
  • Preterm SGA infants exhibited lower Apgar scores at 1 and 5 minutes than term SGA infants.
  • Four out of 21 (19%) neonates with GS expired post-operation.

Conclusions:

  • Small for gestational age (SGA) is a frequent comorbidity in gastroschisis (GS) and is linked to adverse outcomes.
  • These findings offer valuable data for prenatal counseling of parents expecting infants with GS.
  • Long-term follow-up is recommended for infants with gastroschisis, particularly those who are SGA.
Abstract

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