Perinatally Accessible Biomarkers of Complex Gastroschisis: Systematic Review and Individual Patient Data...

To systematically review perinatally accessible body fluid biomarkers of gastroschisis and those associated with disease severity or postnatal morbidities.

PubMed, Embase, Web of Science, Scopus, Cochrane CENTRAL, ClinicalTrials.gov, and the International Clinical Trials Registry Platform were searched for studies reporting body fluid biomarkers obtained from women carrying a fetus or neonates with gastroschisis. The primary aim was to identify biomarkers indicating gastroschisis; secondary aims included identifying biomarkers associated with disease severity (simple vs. complex) or postnatal morbidity.

Twenty-two studies were included, showing substantial heterogeneity in sampling timing, fluid type, and biomarkers assessed. Among 13 studies reporting prenatal biomarkers, amniotic fluid total protein, IL-8, and ferritin differentiated fetuses with gastroschisis from normal fetuses. Total protein correlated with disease severity. Bile acid findings were inconsistent. Increased cord blood IL-8 at delivery was associated with the presence of gastroschisis and prolonged parenteral nutrition. Neonatal urinary intestinal fatty acid-binding protein indicated the presence and severity of gastroschisis. An individual patient data meta-analysis of three studies identified four inflammatory cord blood biomarkers (IL-8, CXCL10, IL-4, and CX3CL1) associated with prolonged parenteral nutrition.

Several perinatally accessible biomarkers are associated with gastroschisis, and some further correlate with severity or postnatal morbidity.