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Outcomes of infants with abdominal wall defects over 18years

Juin Yee Kong1, Kee Thai Yeo1, Mohamed E Abdel-Latif2

  • 1Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia; Department of Neonatology, KK Women's and Children's Hospital, Singapore.

Journal of Pediatric Surgery
|July 2, 2016
PubMed

Insights

Infants with gastroschisis had longer hospital stays and more infections than those with omphalocele. However, omphalocele infants experienced higher mortality rates, while gastroschisis mortality increased over time.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Public Health

Background:

  • Abdominal wall defects (AWD) in infants, including gastroschisis and omphalocele, are associated with significant risks.
  • These risks include prolonged hospitalization, infections, and mortality, impacting infant outcomes.

Purpose of the Study:

  • To describe and compare the clinical outcomes of infants with gastroschisis versus omphalocele.
  • To analyze trends in outcomes for these congenital anomalies over an 18-year period.

Main Methods:

  • A population-based study utilizing clinical data from live-born infants with AWD.
  • Data collected from all tertiary-level neonatal intensive care units in New South Wales and Australian Capital Territory.
  • Study period spanned from 1992 to 2009, encompassing 502 infants with AWD.

Main Results:

  • Infants with gastroschisis (n=336) required longer total parenteral nutrition (19 vs. 4 days) and hospitalization (28 vs. 15 days) compared to omphalocele (n=166).
  • Gastroschisis cases showed higher systemic infection rates (23.5% vs. 13.3%).
  • Omphalocele infants had a higher overall mortality rate (OR 2.77), while gastroschisis mortality increased from 4.2% to 8.8% over the study period.

Conclusions:

  • Gastroschisis is associated with prolonged hospitalization, parenteral nutrition, and increased infection risk compared to omphalocele.
  • Omphalocele presents a higher overall mortality risk, despite gastroschisis mortality rates rising.
  • The increasing trend in gastroschisis mortality warrants further investigation.
Abstract

Keywords:
Abdominal wall defectGastroschisisMortalityNeonateOmphaloceleOutcomes

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