Pre- and postnatal diagnosis and outcome of fetuses and neonates with esophageal atresia and tracheoesophageal fistula.
OBJECTIVE
Clinical symptoms and ultrasound signs during pregnancy could suggest the presence of esophageal atresia (EA). However, most often EA is diagnosed postnatally. The aim of our study is to evaluate the course and outcome for prenatally and postnatally diagnosed EA. In addition, we studied the outcome of isolated versus nonisolated EA.


METHODS
In a retrospective data analysis, ultrasound characteristics, maternal and neonatal variables as well as clinical outcome were compared for fetuses/neonates with prenatal (n = 30) or postnatal (n = 49) diagnosis of EA. Clinical outcome in terms of morbidity and mortality of isolated EA was compared with that of EA complicated by chromosomal or structural anomalies.


RESULTS
Prenatally diagnosed children were born 2 weeks earlier than postnatally diagnosed children (36.4 weeks vs 38.2 weeks; P = 0.02). The former had higher mortality rates (30 vs 12%; P = 0.05) and more associated anomalies (80 vs 59%; P = 0.04). In both subsets, there was a high morbidity rate in the survivors (not significant). Nonisolated EA was associated with greater occurrence of polyhydramnios (53 vs 27%; P = 0.04) and higher mortality rate (28 vs 0%; P = 0.002).


CONCLUSIONS
Mortality was significantly higher in prenatally diagnosed infants and in infants with additional congenital anomalies. Isolated EA is associated with good outcome.
de Jong
E M
EM
Department of Pediatric Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
de Haan
M A M
MA
Gischler
S J
SJ
Hop
W
W
Cohen-Overbeek
T E
TE
Bax
N M A
NM
de Klein
A
A
Tibboel
D
D
Grijseels
E W M
EW
D000328:Adult; D025063:Chromosome Disorders / Q000175:diagnosis / Q000401:mortality; D015897:Comorbidity; D004933:Esophageal Atresia / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D006831:Polyhydramnios / Q000175:diagnosis / Q000401:mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D015996:Survival Rate; D014138:Tracheoesophageal Fistula / Q000151:congenital / Q000000981:diagnostic imaging* / Q000401:mortality; D016216:Ultrasonography, Prenatal