Postnatal outcome in gastroschisis: effect of birth weight and gestational age.
BACKGROUND
Early elective delivery of antenatally diagnosed gastroschisis has been proposed as a strategy to minimize postnatal morbidity. This hypothesis was tested by analyzing outcome in relationship to gestational age and birth weight at delivery.


METHODS
Single-center retrospective review of infants born with gastroschisis over a 13-year period (January 1993-December 2005). Standard outcome measures were compared using nonparametric methods. Data are quoted as median values (range).


RESULTS
The study population consisted of 110 infants with gastroschisis. They were divided according to gestational age (group A, <35 weeks; group B, 35-37 weeks; group C, >37 weeks) and birth weight (group D, <2 kg; group E, 2-2.5 kg; group F, >2.5 kg). Duration in hospital (P < .01) and time to full enteral feeding (P = .05) was increased in group A vs groups B and C. In comparison, duration in hospital (P < .01), days ventilated (P = .03), establishment of full feeds (P = .01), and parenteral nutrition (P = .02) were all prolonged in group D vs groups E and F. Six (5%) infants died (group D, n = 3; group E, n = 3). Necrotizing enterocolitis was found in 7 infants, and confined to groups D and E (chi2 for trend P = .06).


CONCLUSIONS
There is no evidence that prematurity confers an advantage in restitution of gastrointestinal function in infants with gastroschisis; indeed, the opposite appears true. Birth weight, rather than gestational age, appears a better predictor of outcome.
Charlesworth
Paul
P
Department of Paediatric Surgery, King's College Hospital, Denmark Hill, SE5 9RS London, UK.
Njere
Ike
I
Allotey
Jacqueline
J
Dimitrou
Gabriel
G
Ade-Ajayi
Niyi
N
Devane
Sean
S
Davenport
Mark
M
D000704:Analysis of Variance; D001724:Birth Weight; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric; D005260:Female; D020139:Gastroschisis / Q000473:pathology* / Q000601:surgery; D005865:Gestational Age; D006801:Humans; D018529:Nutritional Support / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D011296:Prenatal Diagnosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018709:Statistics, Nonparametric