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Associated congenital anomalies in infants with isolated gastroschisis: A single-institutional experience
Jorge Román Corona-Rivera1,2, Rafael Nieto-García3, Eloy López-Marure4
1Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, Dr. Juan I. Menchaca Civil Hospital of Guadalajara, Guadalajara, Jalisco, México.
Insights
Nearly half of infants with gastroschisis have associated anomalies (AA). Secondary AA, including intestinal and extraintestinal issues, are linked to poorer outcomes, unlike primary AA.
Area of Science:
- Pediatric Surgery
- Neonatalogy
- Medical Genetics
Background:
- Gastroschisis is a congenital defect with varying associated anomalies (AA).
- Understanding the frequency and impact of AA in gastroschisis is crucial for patient management.
Purpose of the Study:
- To determine the frequency and types of associated congenital anomalies in isolated gastroschisis.
- To explore the association of these anomalies with outcomes like length of hospital stay and mortality.
Main Methods:
- Retrospective review of 108 cases of isolated gastroschisis (2009-2014).
- Prospective assessment of intestinal and extraintestinal anomalies (secondary and primary).
- Statistical analysis including multivariate logistic regression.
Main Results:
- 48.1% of infants had associated anomalies (AA), with higher odds in males.
- Secondary AA (intestinal and extraintestinal) were present in 34.3% of patients.
- Secondary AA were associated with complex gastroschisis, prolonged hospital stay, and in-hospital death.
Conclusions:
- Secondary associated anomalies significantly impact outcomes in gastroschisis patients.
- Primary associated anomalies did not show a correlation with worse outcomes.
- Thorough investigation and categorization of AA in gastroschisis are vital for predicting prognosis.
Abstract:
The aim of our study was to determine the frequency and type of associated congenital anomalies in patients with isolated gastroschisis born at the Dr. Juan I. Menchaca Civil Hospital of Guadalajara (Guadalajara, México), and to explore its possible association with the included outcome variables. One hundred-eight cases with isolated gastroschisis were reviewed from 2009 to 2014. The occurrence of intestinal and extraintestinal associated anomalies (either secondary or primary) was prospectively assessed. The type of gastroschisis, length of hospital stay (LOS), and in-hospital mortality were outcome variables for statistical analysis. Of infants with gastroschisis, 52 (48.1%) had one or more associated anomalies (AA), with increased odds in males (OR = 2.3, 95%CI: 1.1-5.0). AA classified, as secondary and primary were present in 34.3 and 5.6% of patients, respectively. Of secondary AA, 25.9% were intestinal anomalies, and 17.6% were extraintestinal. Primary AA were congenital heart disease (n = 3), meningomyelocele, and hydrocephaly and amniotic band sequence in one instance, respectively. Multivariate logistic regression showed that secondary AA (both intestinal and extraintestinal) were associated with complex gastroschisis, prolonged LOS, and in-hospital death, whereas primary AA were not related to a worse outcome. Our results highlight the pathogenic importance of properly investigating and categorizing the presence of others secondary or primary AA when diagnosis of gastroschisis is made.
