title: Delivery planning for pregnancies with gastroschisis: findings from a prospective national registry.
abstract: OBJECTIVE
  The purpose of this study was to determine the influence of planned mode and planned timing of delivery on neonatal outcomes in infants with gastroschisis.
  
  
  METHODS
  Data from the Canadian Pediatric Surgery Network cohort were used to identify 519 fetuses with isolated gastroschisis who were delivered at all tertiary-level perinatal centers in Canada from 2005-2013 (n = 16). Neonatal outcomes (including length of stay, duration of total parenteral nutrition, and a composite of perinatal death or prolonged exclusive total parenteral nutrition) were compared according to the 32-week gestation planned mode and timing of delivery with the use of the multivariable quantile and logistic regression.
  
  
  RESULTS
  Planned induction of labor was not associated with decreased length of stay (adjusted median difference, -2.6 days; 95% confidence interval [CI], -9.9 to 4.8), total parenteral nutrition duration (adjusted median difference, -0.2 days; 95% CI, -6.4 to 6.0), or risk of the composite adverse outcome (relative risk, 1.7; 95% CI, 0.1-3.2) compared with planned vaginal delivery after spontaneous onset of labor. Planned delivery at 36-37 weeks' gestation was not associated with decreased length of stay (adjusted median difference, 5.9 days; 95% CI, -5.7 to 17.5), total parenteral nutrition duration (adjusted median difference, 3.2 days; 95% CI, -7.9 to 14.3), or risk of composite outcome (relative risk, 2.3; 95% CI, 0.8-5.4) compared with planned delivery at ≥38 weeks' gestation.
  
  
  CONCLUSIONS
  Infants with gastroschisis who were delivered after planned induction or planned delivery at 36-37 weeks' gestation did not have significantly better neonatal outcomes than planned vaginal delivery after spontaneous onset of labor and planned delivery at ≥38 weeks' gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Alya
authors.initials: A
authors.lastname: Al-Kaff
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: smacdonald@mail.harvard.edu.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: MacDonald
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kent
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Burrows
authors.affiliation: Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Erik D
authors.initials: ED
authors.lastname: Skarsgard
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Hutcheon
mesh_terms: D000328:Adult; D002170:Canada; D002585:Cesarean Section / Q000379:methods; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D020139:Gastroschisis; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010288:Parenteral Nutrition / Q000706:statistics & numerical data*; D011247:Pregnancy; D011446:Prospective Studies; D012042:Registries; D062606:Tertiary Care Centers; D013997:Time Factors; D055815:Young Adult
keywords: gastroschisis; labor induction; mode of delivery; timing of delivery