Frequency of anomalies and hospital outcomes in infants with gastroschisis and omphalocele

Abstract

Background Gastroschisis and omphalocele are the most common anterior abdominal wall defects affecting infants. There are few large cohort studies describing the frequency of associated anomalies in infants with these 2 conditions. We describe associated anomalies and outcomes in infants with these defects using a large, multi-center clinical database. Methods We identified all infants with gastroschisis or omphalocele from a prospectively collected database of infants discharged from 348 neonatal intensive care units in North America from 1997–2012. Maternal and patient demographic data, associated anomalies, and outcome data were compared between infants with gastroschisis and omphalocele. Results A total of 4687 infants with gastroschisis and 1448 infants with omphalocele were identified. Infants with omphalocele were more likely to be diagnosed with at least 1 other anomaly compared with infants with gastroschisis (35% vs. 8%, p<0.001). Infants with omphalocele were more likely to develop pulmonary hypertension compared with those with gastroschisis (odds ratio [OR] 7.78; 95% confidence interval 5.81, 10.41) and had higher overall mortality (OR 6.81 [5.33, 8.71]). Conclusion Infants with omphalocele were more likely to have other anomalies, be diagnosed with pulmonary hypertension, and have higher mortality than infants with gastroschisis.

Prevalence, timing of diagnosis and pregnancy outcome of abdominal wall defects after the introduction of a national prenatal screening program

“…Exomphalos is the herniation of intra‐abdominal organs through the umbilical ring into the cord, covered by the peritoneal membrane . Mortality and morbidity rates for children with exomphalos are high, since over half of the cases are associated with additional anomalies . Gastroschisis is a defect in the abdominal wall, exposing the small intestines without coverage of a membrane.…”

Abdominal wall defects: omphalocele and gastrschisis

“…Omfaloselde kardiak %11-24, gastrointestinal %7, nörolojik %4, pulmoner %3, genetik, %15, renal anomali %6 oranında görülür (14) .…”

“…(14) çok merkezli bir çalışmada, omfalosellerde genetik sendromların ve ekstraintestinal sorunların gastroşizise göre daha fazla olduğunu ve ilaveten omfalosellerde pulmoner hipertansiyonun fazla görülüp prognozda etkili bir faktör olduğunu ileri sürmüşlerdir.…”

“…Kardiak %1, gastrointestinal %5, nörolojik %1, pulmoner %1'den az, genetik %1, renal anomali %1 rapor edilmiştir (14) . Ayrıca ileal atrezi ve hirschsprung hastalığı (78) , inmemiş testis (79) ve bir yıllık takip döneminde gastro özofageal reflü ile birliktelik bildirilmiştir (80) .…”

Sonographic Markers in the Prediction of Fetal Complex Gastroschisis

“…After birth, despite a survival rate of >90% [4,5] , gastroschisis is associated with important morbidity, which results from bowel complications and a prolonged length of hospital stay (LOS) [6,7] . Furthermore, the presence of complex gastroschisis (CG), which involves bowel atresia, stenosis, necrosis, or perforation at birth, is associated with higher mortality and morbidity rates than simple gastroschisis [8] .…”