Perinatal mortality in pregnancies with omphalocele: data from the Chinese national birth defects monitoring network, 1996–2006

Abstract

BackgroundPrevious studies on the mortality rate of omphalocele are limited. The risk of death of non-isolated omphalocele and that of cases of omphalocele that are diagnosed prenatally by ultrasound are unclear. This study aimed to estimate the perinatal mortality of pregnancies with omphalocele. This study also examined the potential risk of death of non-isolated omphalocele and that of cases that are prenatally diagnosed by ultrasound.MethodsData were retrieved from the national birth defects registry in China, for 1996–2006. Multinomial logistic regression was used to calculate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) between perinatal mortality and selected maternal and fetal characteristics.ResultsAmong 827 cases of omphalocele, 309 (37.4%) cases resulted in termination of pregnancy and stillbirth, and 124 (15.0%) cases resulted in death in the first 7 days after delivery, yielding a perinatal mortality rate of 52.4% (95% CI: 49.0–55.8%). The late fetal death rate (LFDR) of omphalocele that was diagnosed prenatally by ultrasound was 15.91-fold (AOR: 15.91, 95% CI: 10.18–24.87) higher than that of postnatally diagnosed cases. The LFDR of non-isolated omphalocele was 2.64-fold (AOR: 2.64, 95% CI: 1.62–4.29) higher than that of isolated cases. For the early neonatal death rate, neonates with non-isolated omphalocele had a 2.96-fold (AOR: 2.96, 95% CI: 1.82–4.81) higher risk than isolated cases, but the difference between prenatal ultrasound diagnosis and postnatal diagnosis was not significant.ConclusionsSelected fetal characteristics are significantly associated with the perinatal risk of death from omphalocele. Our findings suggest that improving pregnancy and delivery care, as well as management for omphalocele are important.

Study on the prevalence and neonatal lethality in patients with selected congenital anomalies as per the data of the National Registry of Congenital Anomalies of Argentina

“…19 Neonatal lethality for gastroschisis, omphalocele and esophageal atresia observed in other investigations was generally below the rates observed in our study. [20][21][22] Consistent with our work, several studies have associated prematurity to a higher mortality rate among infants affected with selected CAs. 18,20,[23][24][25] However, some investigations conducted in gastroschisis patients have demonstrated that elective preterm C-sections prevented the occurrence of intestinal inflammation and improved enteral functioning because the exposure time of bowel loops to amniotic fluid meconium was shorter.…”

Estudio de prevalencia y letalidad neonatal en pacientes con anomalías congénitas seleccionadas con datos del Registro Nacional de Anomalías Congénitas de Argentina

“…19 La letalidad neonatal en gastrosquisis, onfalocele y atresia esofágica observada en otras investigaciones ha estado, en general, por debajo de las cifras observadas en nuestro estudio. [20][21][22] Concordante con nuestro estudio, la prematurez ha sido asociada en varios trabajos a una mayor tasa de mortalidad en afectados con las AC seleccionadas. 18,20,[23][24][25] Sin embargo, algunas investigaciones realizadas en pacientes con gastrosquisis han mostrado que las cesáreas electivas pretérmino evitaron la aparición de daño inflamatorio intestinal y mejoraron el funcionamiento enteral por presentar menor tiempo de exposición de las asas al meconio del líquido amniótico.…”

Major abdominal wall defects in the low- and middle-income setting: current status and priorities

“…Pre-and perinatal mortality is high in omphalocele. A large cohort study revealed that 37% of the cases had termination of pregnancy or stillbirth, an additionally 15% died within the first 15 days after delivery, and that prenatally diagnosed and non-isolated omphaloceles had a significant higher mortality than postnatally diagnosed and isolated cases [41].…”