Prevalence of Critical Congenital Heart Defects Among Neonates Born With Abdominal Wall Defects

We hypothesized that there is a higher prevalence of critical congenital heart defects (CCHD) among infants born with gastroschisis, which leads to worse outcomes during index neonatal intensive care unit (NICU) admission.

Rates of gastroschisis, omphalocele, and CCHD were calculated from Department of Health and Human Services (HHS) annual data on all live births in the US. Separately, NICU admissions to the Pediatric Health Information System (PHIS) between 2017 and 2023 were analyzed for diagnosis of gastroschisis, omphalocele, or CCHD, as identified by ICD-10 codes.

Neonates diagnosed with gastroschisis carried a concomitant diagnosis of CCHD more frequently than the general population (OR = 8.18, 95% CI 5.56-12.02). Among NICU admissions to PHIS hospitals, neonates diagnosed with both gastroschisis and CCHD had higher rates of open cardiac surgery (OR = 12.20, 95% CI 2.36-63.08, p < 0.001) and mortality (OR = 9.56, 95% CI 1.72-53.07, p = 0.004) during index admission compared to the general NICU population.

The current study demonstrates that infants born with gastroschisis are more likely to be diagnosed with CCHD than the general population. A diagnosis of both gastroschisis and CCHD resulted in higher rates of open cardiac surgery and mortality during index hospital admission.