Management and outcome challenges in newborns with gastroschisis: A 6-year retrospective French study

J Matern Fetal Neonatal Med. 2017 Dec;30(23):2864-2870. doi: 10.1080/14767058.2016.1265935. Epub 2016 Dec 14.


Objective: To identify the gestational age (GA) at which risk of mortality and severe outcome was minimized comparing preterm delivery and expectant management.

Methods: Retrospective study performed between 2009 and 2014 of newborns with gastroschisis in three large French level III neonatal intensive care units. Each department followed two distinct strategies: elective delivery at 35 weeks' GA and a delayed approach.

Results: We included 69 gastroschisis cases. The lengths of stay lasting more than 60 days were significantly greater in the planned delivery group than in the expectant approach group (18/30 (60%) vs. 8/39 (20.5%), p = 0.001). Gastroschisis cases receiving antenatal corticoids during the last two weeks of gestation required significantly less surgeries during their initial stay (p = 0.003) as well as shorter parenteral feedings (p = 0.002). A multivariate logistic regression showed that a GA of less than 36 weeks' GA was is a pejorative factor for a stay above 60 days, regardless of whether it was a simple or complex gastroschisis, (OR= 3.8; p = 0.021). A complex gastroschisis was a risk factor for significantly longer parenteral feedings, regardless of the center where patient is treated (Beta = -0.3, p = 0.035).

Conclusions: Future research should focus on decisions about delivery timing by incorporating risk of neonatal morbidity.

Keywords: Gastroschisis; delivery timing; neonatal outcome; postnatal outcome; preterm delivery.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Gastroschisis / diagnosis*
  • Gastroschisis / epidemiology
  • Gastroschisis / therapy*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnosis*
  • Infant, Newborn, Diseases / epidemiology
  • Infant, Newborn, Diseases / therapy*
  • Male
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult