Delivery of gastroschisis patients before 37 weeks of gestation is associated with increased morbidities

Abstract Background Despite advances in the care of neonates with gastroschisis, patients present with significant morbidities. Preterm delivery of neonates with gastroschisis is often advocated to avoid the intestinal damage that may be sustained with prolonged exposure to amniotic fluid. However,...

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Bibliographic Details
Published in:Journal of pediatric surgery 2009-07, Vol.44 (7), p.1360-1366
Main Authors: Maramreddy, Hima, Fisher, Joie, Slim, Michael, LaGamma, Edmund F, Parvez, Boriana
Format: Article
Language:English
Subjects:
Birth Weight
Delivery, Obstetric - statistics & numerical data
Female
Follow-Up Studies
Gastroschisis
Gastroschisis - epidemiology
Gestational Age
Growth
Humans
Infant, Newborn
Late preterm
Morbidities
Morbidity - trends
New York - epidemiology
Pediatrics
Pregnancy
Preterm
Retrospective Studies
Risk Factors
Surgery
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Summary:Abstract Background Despite advances in the care of neonates with gastroschisis, patients present with significant morbidities. Preterm delivery of neonates with gastroschisis is often advocated to avoid the intestinal damage that may be sustained with prolonged exposure to amniotic fluid. However, preterm delivery may impose additional morbidities to this disease process. Methods We conducted a retrospective review of patients with gastroschisis born from 1989 to 2007. Demographic and clinical data were collected. Preterm healthy neonates, with gestational age from 26 to 36 weeks, were used as controls. Results Preterm infants with gastroschisis had a 14 times higher risk for any of the recorded morbidities. As compared to term neonates with gastroschisis, preterm neonates with gastroschisis had a higher rate of sepsis, longer duration to reach full enteral feedings, and longer length of stay. Although the preterm infants with gastroschisis were less likely to be small for gestational age at birth, they were as likely as the term infants with gastroschisis to have failure to thrive at discharge and had a greater drop in weight percentile during hospitalization. Conclusions Preterm delivery should be avoided because there is no clear benefit to the gut in avoiding derivative injuries. Meticulous attention should be given to the nutritional needs of patients with gastroschisis.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2009.02.006