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Prenatal Ultrasound Markers of Adverse Perinatal Outcomes in Newborns With Simple and Complex Gastroschisis
João Victor Jacomele Caldas1, Alberto Borges Peixoto2,3, Liliam Cristine Rolo1
1Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, São Paulo, Brazil.
Objective:
The aim of this study was to compare prenatal ultrasound markers and perinatal outcomes in newborns with simple and complex gastroschisis.
Methods:
A retrospective cohort study was performed on pregnant women with gastroschisis fetuses and their respective newborns between 2009 and 2019. Binary logistic regression was used to determine the best prenatal ultrasound markers of complex gastroschisis and adverse perinatal outcomes.
Results:
After delivery, 36 gastroschisis were classified as simple and 10 as complex. Newborns with complex gastroschisis had a higher prevalence of early neonatal death compared to newborns with simple gastroschisis (30.0% vs. 2.8%, p = 0.007). The abdominal wall defect diameter became a significant prenatal ultrasound marker of neonatal sepsis [X2: 6.31 (1), OR:0.92, CI 95% (0.85-0.98), p = 0.020]. The presence of complex gastroschisis [X2: 7.33 (1), OR: 23.25, CI 95% 1.92-280.77, p = 0.013] was the only significant predictor of early neonatal death, and the presence of complex gastroschisis increased the risk of early neonatal death by 23.25 times. There was no significant effect of the type of gastroschisis in relation to gestational age, amniotic fluid index, intra-abdominal intestinal dilation, extra-abdominal intestinal dilation, and thickness of the intestine diameter.
Conclusion:
Abdominal wall defect diameter was a significant prenatal ultrasound marker of adverse perinatal outcomes in newborns with simple and complex gastroschisis. Complex gastroschisis was a significant predictor of early neonatal death.
