Outcomes of multi-gestational pregnancies affected by esophageal atresia - tracheoesophageal fistula

J Pediatr Surg. 2019 Oct;54(10):2080-2083. doi: 10.1016/j.jpedsurg.2019.04.026. Epub 2019 May 6.

Abstract

Background: Contemporary outcomes of infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) from multi-gestational pregnancies compared to those of singleton pregnancies have not been reported.

Methods: A single-center retrospective review of EA/TEF patients born from 1999 to 2013 was performed. Patient demographics, gestational age (GA), birth weight, associated anomalies, requirement for gastrostomy tube and mortality were reviewed.

Results: Singleton EA/TEF patients outnumbered those from multi-gestational pregnancies nearly 10:1 (214 vs 22 patients). EA/TEF patients from multi-gestational pregnancies were more likely to be premature (77% vs. 32%), have lower birth weight (mean 1766 g vs. 2695 g), have associated duodenal atresia (18% vs. 6%) and require gastrostomy tube (41% vs. 33%) for feeding challenges compared to EA/TEF singletons. Mortality was also significantly greater for multi-gestational EA/TEF patients compared to singleton EA/TEF patients (18% vs. 6%).

Conclusion: EA/TEF infants from multi-gestational pregnancies have greater clinical complexity and mortality than singleton EA/TEF patients. Parents of EA/TEF multi-gestational infants should be appropriately counseled and supported.

Keywords: Congenital anomalies; Esophageal atresia; Morbidity; Mortality; Singleton pregnancy; Twin pregnancy.

MeSH terms

  • Esophageal Atresia* / epidemiology
  • Esophageal Atresia* / mortality
  • Esophageal Atresia* / surgery
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases* / epidemiology
  • Infant, Newborn, Diseases* / mortality
  • Infant, Newborn, Diseases* / surgery
  • Pregnancy
  • Pregnancy, Multiple / statistics & numerical data*
  • Retrospective Studies
  • Tracheoesophageal Fistula* / epidemiology
  • Tracheoesophageal Fistula* / mortality
  • Tracheoesophageal Fistula* / surgery
  • Treatment Outcome

Supplementary concepts

  • Esophageal atresia with or without tracheoesophageal fistula