title: Factors associated with gastroschisis outcomes.
abstract: OBJECTIVE
  To identify perinatal variables associated with adverse outcomes in neonates prenatally diagnosed with gastroschisis.
  
  
  METHODS
  A retrospective review was conducted of all inborn pregnancies complicated by gastroschisis within the five institutions of the University of California Fetal Consortium from 2007 to 2012. The primary outcome was a composite adverse neonatal outcome comprising death, reoperation, gastrostomy, and necrotizing enterocolitis. Variables collected included antenatal ultrasound findings, maternal smoking or drug use, gestational age at delivery, preterm labor, elective delivery, mode of delivery, and birth weight. Univariate and multivariate analysis was used to assess factors associated with adverse outcomes. We also evaluated the association of preterm delivery with neonatal outcomes such as total parenteral nutrition cholestasis and length of stay.
  
  
  RESULTS
  There were 191 neonates born with gastroschisis in University of California Fetal Consortium institutions at a mean gestational age of 36 3/7±1.8 weeks. Within the cohort, 27 (14%) had one or more major adverse outcomes, including three deaths (1.6%). Early gestational age at delivery was the only variable identified as a significant predictor of adverse outcomes on both univariate and multivariate analysis (odds ratio 1.4, 95% confidence interval 1.1-1.8 for each earlier week of gestation). Total parenteral nutrition cholestasis was significantly more common in neonates delivered at less than 37 weeks of gestation (38/115 [33%] compared with 11/76 [15%]; P<.001).
  
  
  CONCLUSIONS
  In this contemporary cohort, earlier gestational age at delivery is associated with adverse neonatal outcomes in neonates with gastroschisis. Other variables, such as antenatal ultrasound findings and mode of delivery, did not predict adverse neonatal outcomes.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Reproductive Medicine, University of California San Diego, San Diego, the Division of Pediatric Surgery, Department of Surgery and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, the Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of California Irvine, Irvine, the Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California San Francisco, San Francisco, and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and the Division of Neonatology, Department of Pediatrics, University of California Davis, Davis, California.
authors.forename: Rachael T
authors.initials: RT
authors.lastname: Overcash
authors.forename: Daniel A
authors.initials: DA
authors.lastname: DeUgarte
authors.forename: Megan L
authors.initials: ML
authors.lastname: Stephenson
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Gutkin
authors.forename: Mary E
authors.initials: ME
authors.lastname: Norton
authors.forename: Sima
authors.initials: S
authors.lastname: Parmar
authors.forename: Manuel
authors.initials: M
authors.lastname: Porto
authors.forename: Francis R
authors.initials: FR
authors.lastname: Poulain
authors.forename: David B
authors.initials: DB
authors.lastname: Schrimmer
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000209:etiology; D005260:Female; D020139:Gastroschisis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005774:Gastrostomy / Q000706:statistics & numerical data; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D015999:Multivariate Analysis; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data