Oesophageal atresia in premature infants: an analysis of morbidity and mortality over a period of 20 years.
OBJECTIVE
To determine the morbidity and mortality of premature infants born with oesophageal atresia (OA) and to evaluate historical changes in morbidity and mortality over time.


METHODS
Retrospective analysis of morbidity and mortality of all patients admitted for OA, with or without tracheo-oesophageal fistula, between 1982 and 2002.


RESULTS
The study group consisted of 197 consecutive patients, of whom 55 (28%) were premature and 21 (11%) very premature. Type A atresia was found more often in very premature and premature infants than in those born at term (p = 0.02). Type E atresia was not found in the premature group (p = 0.004). At least one associated congenital anomaly was also present in 121 patients (61%). Postoperative complications developed more often in very premature and premature infants than in those born at term (p < 0.001). Gastro-oesophageal reflux was diagnosed in 32/76 premature infants and in 41/121 term infants (p = 0.001). Mortality among very premature and premature infants was higher than among those born at term (p = 0.003). Withdrawal of treatment was the most frequent cause of death.


CONCLUSIONS
Premature infants with OA have a higher morbidity and mortality than term infants with OA. The complications of prematurity contribute significantly to morbidity and mortality in premature infants with OA. There is no reason to refrain from the standard treatment of OA in premature infants with no severe associated congenital anomalies.
Deurloo
J A
JA
Paediatric Surgical Centre of Amsterdam, Emma Children's Hospital AMC/Vrije University Medical Centre, Amsterdam, The Netherlands.
Smit
B J
BJ
Ekkelkamp
S
S
Aronson
D C
DC
D002423:Cause of Death; D015897:Comorbidity; D004933:Esophageal Atresia / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male; D006831:Polyhydramnios / Q000453:epidemiology; D011247:Pregnancy