title: Effect of gestational age at birth on neonatal outcomes in gastroschisis.
abstract: BACKGROUND
  Induced birth of fetuses with gastroschisis from 34weeks gestational age (GA) has been proposed to reduce bowel damage. We aimed to determine the effect of birth timing on time to full enteral feeds (ENT), length of hospital stay (LOS), and sepsis.
  
  
  METHODS
  A retrospective analysis (2000-2014) of gastroschisis born at ≥34weeks GA was performed. Associations between birth timing and outcomes were analyzed by Mann-Whitney test, Cox regression, and Fisher's exact test.
  
  
  RESULTS
  217 patients were analyzed. Although there was no difference in ENT between those born at 34-36+6weeks GA (median 28 range [6-639] days) compared with ≥37weeks GA (27 [8-349] days) when analyzed by Mann-Whitney test (p=0.5), Cox regression analysis revealed that lower birth GA significantly prolonged ENT (p=0.001). LOS was significantly longer in those born at 34-36+6weeks GA (42 [8-346] days) compared with ≥37weeks GA 34 [11-349] days by both Mann-Whitney (p=0.02) and Cox regression analysis (p<0.0005). Incidence of sepsis was higher in infants born at 34-36+6weeks (32%) vs. infants born at ≥37weeks (17%; p=0.02).
  
  
  CONCLUSIONS
  Early birth of fetuses with gastroschisis was associated with delay in reaching full enteral feeds, prolonged hospitalization, and a higher incidence of sepsis.
authors.affiliation: UCL Institute of Child Health and Great Ormond Street Hospital for Children, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Carnaghan
authors.affiliation: Maternal-Fetal Medicine Unit, Mount Sinai Hospital, Toronto, Ontario, Canada; Materno-fetal and Obstetrics Research Unit, Department of Obstetrics and Gynecology, Maternity, University Hospital, Lausanne, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Baud
authors.affiliation: Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Eveline
authors.initials: E
authors.lastname: Lapidus-Krol
authors.affiliation: Maternal-Fetal Medicine Unit, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Ryan
authors.affiliation: Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Prakesh S
authors.initials: PS
authors.lastname: Shah
authors.affiliation: Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Agostino
authors.initials: A
authors.lastname: Pierro
authors.affiliation: UCL Institute of Child Health and Great Ormond Street Hospital for Children, London, UK. Electronic address: s.eaton@ucl.ac.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Eaton
mesh_terms: D036861:Delivery, Obstetric / Q000379:methods*; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D020139:Gastroschisis / Q000503:physiopathology* / Q000628:therapy; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011181:Postnatal Care; D011247:Pregnancy; D011296:Prenatal Diagnosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology; D018709:Statistics, Nonparametric; D013997:Time Factors
keywords: Enteral feeding; Gastroschisis; Gestational age; Neonatal outcome; Postnatal outcome; Preterm delivery