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High risk of spontaneous preterm birth among infants with gastroschisis

Rebecca J Baer1,2, Christina D Chambers1, Kelli K Ryckman3

  • 1Department of Pediatrics, University of California San Diego, La Jolla, California.

American Journal of Medical Genetics. Part A
|December 15, 2018
PubMed

Insights

Infants with gastroschisis face a significantly higher risk of preterm birth (PTB), especially spontaneous PTB. These infants are also at increased risk for severe complications, including those born before 34 weeks.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Health
  • Pediatric Surgery

Background:

  • Gastroschisis is a congenital condition with known associations with adverse birth outcomes.
  • Preterm birth (PTB) is a major risk factor for neonatal morbidity and mortality.
  • Understanding the specific risks of PTB in infants with gastroschisis is crucial for clinical management.

Purpose of the Study:

  • To investigate the association between gastroschisis and preterm birth (PTB) by subtype.
  • To quantify the risk of PTB in infants with gastroschisis compared to those without.
  • To identify specific PTB etiologies and gestational age risks in infants with gastroschisis.

Main Methods:

  • Analysis of a large California birth cohort (2007-2012) including singleton live births.
  • Calculation of relative risks (RRs) and 95% confidence intervals (CIs) for PTB.
  • Adjustment for maternal characteristics and stratification by PTB subtype (spontaneous, PPROM, provider-initiated) and gestational age (<34, 34-36, <37 weeks).

Main Results:

  • Over 53% of infants with gastroschisis experienced PTB, compared to 6.9% without (adjusted RR 15.2).
  • Spontaneous etiologies accounted for over 44% of PTB in gastroschisis cases, with 8.4% born <34 weeks (adjusted RRs 9.1-12.2).
  • Nearly 9% of infants with gastroschisis were born <34 weeks, irrespective of etiology, highlighting significant risk for PTB morbidities.

Conclusions:

  • Infants with gastroschisis are at substantially increased risk for PTB, particularly spontaneous PTB.
  • Early gestational age delivery (<34 weeks) in gastroschisis cases, regardless of cause, poses severe risks for neonatal complications.
  • These findings underscore the need for specialized perinatal care and monitoring for infants diagnosed with gastroschisis.

Keywords:
early preterm birthgastroschisispreterm birthspontaneous preterm birth

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