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Factors associated with gastroschisis outcomes
Rachael T Overcash1, Daniel A DeUgarte, Megan L Stephenson
1Division of Maternal Fetal Medicine, Department of Reproductive Medicine, University of California San Diego, San Diego, the Division of Pediatric Surgery, Department of Surgery and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, the Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of California Irvine, Irvine, the Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California San Francisco, San Francisco, and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and the Division of Neonatology, Department of Pediatrics, University of California Davis, Davis, California.
Early delivery increases adverse outcomes for neonates with gastroschisis. This study found that earlier gestational age at birth was a significant predictor of complications, including death and necrotizing enterocolitis.
Area of Science:
- Perinatal medicine
- Neonatology
- Pediatric surgery
Background:
- Gastroschisis is a congenital defect with significant neonatal morbidity.
- Identifying predictors of adverse outcomes is crucial for improving management.
Purpose of the Study:
- To determine perinatal factors associated with adverse outcomes in neonates diagnosed prenatally with gastroschisis.
Main Methods:
- Retrospective review of 191 neonates with gastroschisis (2007-2012) across five institutions.
- Adverse outcomes included death, reoperation, gastrostomy, and necrotizing enterocolitis.
- Analysis assessed associations between perinatal variables and outcomes.
Main Results:
- 14% of neonates experienced at least one adverse outcome; 1.6% died.
- Earlier gestational age at delivery was the sole significant predictor of adverse outcomes (OR 1.4 per week).
- Preterm delivery (<37 weeks) was linked to higher rates of total parenteral nutrition cholestasis.
Conclusions:
- Earlier gestational age at delivery is a key predictor of adverse neonatal outcomes in gastroschisis.
- Antenatal ultrasound findings and delivery mode did not predict adverse outcomes in this cohort.
