Predicting adverse neonatal outcomes in fetuses with abdominal wall defects using prenatal risk factors

Objective The aim of this study was to determine whether prenatal variables can predict adverse neonatal outcomes in fetuses with abdominal wall defects. Study Design A retrospective cohort study that used ultrasound and neonatal records for all cases of gastroschisis and omphalocele seen over a 16-...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2009-10, Vol.201 (4), p.383.e1-383.e6
Main Authors: Nicholas, Sara S., MD, Stamilio, David M., MD, MSCE, Dicke, Jeffery M., MD, Gray, Diana L., MD, Macones, George A., MD, MSCE, Odibo, Anthony O., MD, MSCE
Format: Article
Language:English
Subjects:
Adult
adverse outcomes
Biological and medical sciences
Female
Fetal Growth Retardation - epidemiology
gastroschisis
Gastroschisis - epidemiology
Gynecology. Andrology. Obstetrics
Hernia, Umbilical - epidemiology
Humans
Maternal Age
Medical sciences
Obstetrics and Gynecology
omphalocele
Polyhydramnios - epidemiology
Pregnancy
Pregnancy Outcome
Risk Factors
ROC Curve
ultrasound predictors
Young Adult
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Summary:Objective The aim of this study was to determine whether prenatal variables can predict adverse neonatal outcomes in fetuses with abdominal wall defects. Study Design A retrospective cohort study that used ultrasound and neonatal records for all cases of gastroschisis and omphalocele seen over a 16-year period. Cases with adverse neonatal outcomes were compared with noncases for multiple candidate predictive factors. Univariable and multivariable statistical methods were used to develop the prediction models, and effectiveness was evaluated using the area under the receiver operating characteristic curve. Results Of 80 fetuses with gastroschisis, 29 (36%) had the composite adverse outcome, compared with 15 of 33 (47%) live neonates with omphalocele. Intrauterine growth restriction was the only significant variable in gastroschisis, whereas exteriorized liver was the only predictor in omphalocele. The areas under the curve for the prediction models with gastroschisis and omphalocele are 0.67 and 0.74, respectively. Conclusion Intrauterine growth restriction and exteriorization of the liver are significant predictors of adverse neonatal outcome with gastroschisis and omphalocele.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2009.06.032