Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study

J Pediatr Surg. 2013 Aug;48(8):1688-96. doi: 10.1016/j.jpedsurg.2012.11.046.

Abstract

Background: The aim of the study was to describe the physical growth and developmental outcomes of babies born with gastroschisis.

Methods: We retrospectively reviewed all cases of gastroschisis in Western Australia born between 1997 and 2010.

Results: In the 128 pregnancies with fetal gastroschisis, 117 babies were live born. 112 (95.7%) survived to one year. 19% had z scores of<-1.28 for weight at birth (<10th centiles) compared with 30% at one year. Neurodevelopmental data were available in 88/112 (79%) of survivors (Griffiths scores in 67; reports of ages and stages questionnaire (ASQ) in 21). The mean GQ at 12 months was 99 (SD 9.8). Suboptimal neurodevelopmental outcomes were noted in eight. Complex gastroschisis (present at birth) and acquired gut related complications were associated with adverse long term outcomes. The incidence of acquired gut complications was least (5%) in those who underwent silo reduction as the primary management. However, on univariate and multivariate analysis, the type of primary reduction did not significantly influence the outcome.

Conclusions: A large proportion of infants with gastroschisis exhibit suboptimal weight gain during the first year. The incidence of adverse developmental outcomes appears to be low.

Keywords: ASQ; Ages and Stages Questionnaire; CDC; Centers for Disease Control and Prevention; GA; GQ; Gastroschisis; General Anesthesia; General Quotient; Growth; IQ; IQR; Intelligence Quotient; Inter-Quartile Range; Neurodevelopmental outcomes; SD; Standard Deviation; TPN; Total Parenteral Nutrition.

MeSH terms

  • Abnormalities, Multiple / epidemiology
  • Adult
  • Comorbidity
  • Delivery, Obstetric
  • Developmental Disabilities / epidemiology*
  • Developmental Disabilities / etiology
  • Digestive System Surgical Procedures / statistics & numerical data
  • Enteral Nutrition
  • Failure to Thrive / epidemiology
  • Failure to Thrive / etiology
  • Female
  • Gastroschisis / epidemiology
  • Gastroschisis / surgery*
  • Growth Disorders / epidemiology*
  • Growth Disorders / etiology
  • Hospital Mortality
  • Hospitals, Pediatric / statistics & numerical data
  • Hospitals, Special / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / surgery
  • Length of Stay / statistics & numerical data
  • Male
  • Maternal Age
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Pregnancy
  • Retrospective Studies
  • Severity of Illness Index
  • Stillbirth / epidemiology
  • Surveys and Questionnaires
  • Survival Rate
  • Tertiary Care Centers / statistics & numerical data
  • Treatment Outcome
  • Weight Gain
  • Western Australia / epidemiology
  • Young Adult