Predicting the outcome of newborns with gastroschisis

J Pediatr Surg. 2009 May;44(5):918-23. doi: 10.1016/j.jpedsurg.2009.01.036.

Abstract

Objective: The objective of the study was to determine factors predicting outcome in newborns with gastroschisis.

Methods: A retrospective analysis of 155 consecutive cases admitted from 1 January 1990 to 31 December 2007 was performed. Prenatal ultrasound findings were available for 89 of 155 (57%) patients and were compared with final outcome. Both univariate and multiple regression analyses were used.

Results: All patients survived to discharge home. The primary outcome measure was length of stay. Multiple regression identified 4 factors associated with length of stay: (1) gestational age (P = .004), (2) nonelective silo (P < .001), (3) gastrointestinal (GI) complication (intestinal atresia, perforation, or resection) (P < .001), and (4) non-GI anomaly (P = .029). Non-GI anomalies occurred in 17 of 155 (11%) patients and tended to increase the risk of a nonelective silo or GI complication (59% vs 39%, P = .190). Dilated bowel (>10 mm) on prenatal ultrasound was associated with GI complications (22% vs 3%, P = .010). However, 78% of patients with dilated bowel on prenatal ultrasound did not have a GI complication. The absence of dilated bowel on prenatal ultrasound accurately predicted the absence of GI complications in 97% of cases.

Conclusion: Prematurity, nonelective silo, GI complications, and non-GI anomalies predict the short-term outcome of newborns with gastroschisis. Prenatal ultrasound serves primarily to predict the absence of GI complications.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / epidemiology
  • Adult
  • Digestive System Abnormalities / epidemiology
  • Dilatation, Pathologic / diagnostic imaging
  • Dilatation, Pathologic / embryology
  • Female
  • Gastroschisis / diagnostic imaging
  • Gastroschisis / embryology
  • Gastroschisis / epidemiology
  • Gastroschisis / surgery*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / diagnostic imaging
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / surgery
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Length of Stay
  • Male
  • Maternal Age
  • Minnesota / epidemiology
  • Pregnancy
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Ultrasonography, Prenatal*