Contemporary Outcomes of Infants with Gastroschisis in North America: A Multicenter Cohort Study

To quantify outcomes and analyze factors predictive of morbidity and mortality in infants with gastroschisis. Clinical data regarding neonates with gastroschisis born between 2009 and 2014 were prospectively collected at 175 North American centers. Multivariate regression was used to assess risk fac...

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Bibliographic Details
Published in:The Journal of pediatrics 2017-09, Vol.188, p.192-197.e6
Main Authors: Fullerton, Brenna S., Velazco, Cristine S., Sparks, Eric A., Morrow, Kate A., Edwards, Erika M., Soll, Roger F., Modi, Biren P., Horbar, Jeffrey D., Jaksic, Tom
Format: Article
Language:English
Subjects:
associated anomalies
Cohort Studies
Congenital Abnormalities - epidemiology
Digestive System Surgical Procedures - statistics & numerical data
Enterocolitis, Necrotizing - epidemiology
Female
Gastroschisis - epidemiology
Gastroschisis - surgery
Gastrostomy - statistics & numerical data
Humans
Infant Nutrition Disorders - epidemiology
Infant, Newborn
Infant, Small for Gestational Age
intestinal atresia
Intestinal Atresia - epidemiology
Intestinal Atresia - surgery
Jejunostomy - statistics & numerical data
Length of Stay - statistics & numerical data
Male
necrotizing enterocolitis
North America - epidemiology
Risk Factors
Sepsis - mortality
surgery
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Summary:To quantify outcomes and analyze factors predictive of morbidity and mortality in infants with gastroschisis. Clinical data regarding neonates with gastroschisis born between 2009 and 2014 were prospectively collected at 175 North American centers. Multivariate regression was used to assess risk factors for mortality and length of stay (LOS). Gastroschisis was diagnosed in 4420 neonates with median birth weight 2410 g (IQR 2105-2747). Survival (discharge home or alive in hospital at 1 year) was 97.8% with a 37 day median LOS (IQR 27-59). Sepsis, defined by positive blood or cerebrospinal fluid culture, was the only significant independent predictor of mortality (P = .04). Significant independent determinants of LOS and the percentage of neonates affected were as follows: bowel resection (9.8%, P 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2017.06.013