A recent study (BS Fullerton et al. J Pediatr 2017; 188: 192-7) reports outcome data from 4420 neonates with gastroschisis from 175 North Amercan centers.
This study, using prospectively-collected data from the Vermont Oxford Network, was restricted to infants with birth weights >1500 g and gestational age >28 weeks.
Key findings from this cohort:
- Survival was 97.8%
- Length of stay (LOS) 37 day median
- Sepsis, confirmed with either positive blood culture or CSF culture, “was the only independent predictor of mortality.”
- In addition to gastroschisis repair, abdominal surgery was needed in 22.3%
- At discharge, 57.0% were <10% weight for age; whereas, only 37.2% were born small for gestational age.
- There were no outcome differences based on mode of delivery (eg. vaginal vs. cesarean)
- Other congenital anomalies were noted in many infants, with 5.8% had an intestinal atresia: 4.6% jejunal/ileal, 1.9% colonic, 0.4% duodenal atresia.
My take: This contemporary study shows excellent survival of neonates with gastroschisis. Sepsis, need for additional surgery, and poor growth remain important challenges.
Related blog posts:
- Increasing Rates of Abdominal Wall Defect (Gastroschisis)
- An unexpected finding with gastroschisis management
- Improving Outlook in Neonatal Nutrition (Part 1)
- Enteral Autonomy in Pediatric Intestinal Failure
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