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Longitudinal growth of children born with gastroschisis or omphalocele
Asta Tauriainen1,2, Samuli Harju3, Arimatias Raitio4
1Department of Pediatric Surgery, University of Eastern Finland and Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland. asta.e.lahtinen@gmail.com.
Insights
Children with gastroschisis and omphalocele experience distinct growth patterns from birth through adolescence. Gastroschisis patients show initial growth failure with catch-up growth, while omphalocele patients exhibit persistent growth deficits.
Area of Science:
- Pediatric Growth and Development
- Congenital Anomalies
- Public Health
Background:
- Normal childhood growth is a key health indicator, but data on children with abdominal wall defects (AWDs) are limited.
- Intrauterine and postnatal growth failure are common in gastroschisis, often followed by catch-up growth.
- While excessive weight gain in puberty is noted in girls with gastroschisis, longitudinal growth patterns for both sexes with gastroschisis or omphalocele require detailed description.
Purpose of the Study:
- To detail and compare the growth phenotypes of children born with gastroschisis or omphalocele against peers without AWDs.
- To analyze growth patterns from birth to adolescence, including weight, length/height, and body mass index.
- To identify distinct growth trajectories associated with gastroschisis and omphalocele.
Main Methods:
- Utilized Finnish nationwide registers and electronic health records for 183 gastroschisis and 144 omphalocele patients (1993-2017).
- Calculated sex- and age-specific Z-scores for weight, length/height, weight-for-length, and BMI.
- Employed linear mixed models for statistical comparisons between patient groups and a reference population.
Main Results:
- Infants with gastroschisis commonly experienced intrauterine growth failure, with significantly lower birth weight and length Z-scores compared to controls.
- Gastroschisis patients showed initial growth failure followed by prominent catch-up growth, faster in girls than boys, reaching peer weight by 5-10 years.
- By adolescence, 30% of gastroschisis patients were overweight; omphalocele patients had normal birth size but remained shorter and lighter than peers until teenage years.
Conclusions:
- Children with gastroschisis and omphalocele exhibit unique growth trajectories from fetal development through adolescence.
- These distinct growth patterns offer potential insights for modulating long-term adult health outcomes.
Abstract:
Normal childhood growth is an indicator of good health, but data addressing the growth of children born with abdominal wall defects (AWDs) are limited. The detailed growth phenotypes of children born with gastroschisis or omphalocele are described and compared to peers without AWDs from birth to adolescence. Data from 183 gastroschisis and 144 omphalocele patients born between 1993 and 2017 were gathered from Finnish nationwide registers and electronic health records. Weight (n = 3033), length/height (n = 2034), weight-for-length (0-24 months, n = 909), and body mass index measures (2-15 years, n = 423) were converted into sex- and age-specific Z-scores. Linear mixed models were used for comparisons. Intrauterine growth failure was common in infants with gastroschisis. Birth weight Z-scores in girls and boys were - 1.2 (0.2) and - 1.3 (0.2) and length Z-scores - 0.7 (0.2) and - 1.0 (0.2), respectively (p < 0.001 for all comparisons to infants without AWDs). During early infancy, growth failure increased in infants with gastroschisis, and thereafter, catch-up growth was prominent and faster in girls than in boys. Gastroschisis children gained weight and reached their peers' weights permanently at 5 to 10 years. By 15 years or older, 30% of gastroschisis patients were overweight. Infants with omphalocele were born with a normal birth size but grew shorter and weighing less than the reference population until the teen-age years.
Conclusion:
Children with gastroschisis and omphalocele have distinct growth patterns from fetal life onwards. These growth trajectories may also provide some opportunities to modulate adult health.
What Is Known:
• Intrauterine and postnatal growth failure can be seen frequently in gastroschisis and they often show significant catch-up growth later in infancy. It is assumed that part of the children with gastroschisis will become overweight during later childhood.
What Is New:
• The longitudinal growth of girls and boys with gastroschisis or omphalocele is described separately until the teenage years. The risk of gaining excessive weight in puberty was confirmed in girls with gastroschisis.
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