Effect of gestational age at birth on neonatal outcomes in gastroschisis.

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Serval ID
serval:BIB_4B453316DF12
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of gestational age at birth on neonatal outcomes in gastroschisis.
Journal
Journal of pediatric surgery
Author(s)
Carnaghan H., Baud D., Lapidus-Krol E., Ryan G., Shah P.S., Pierro A., Eaton S.
ISSN
1531-5037 (Electronic)
ISSN-L
0022-3468
Publication state
Published
Issued date
05/2016
Peer-reviewed
Oui
Volume
51
Number
5
Pages
734-738
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
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.
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).
Early birth of fetuses with gastroschisis was associated with delay in reaching full enteral feeds, prolonged hospitalization, and a higher incidence of sepsis.

Keywords
Delivery, Obstetric/methods, Enteral Nutrition/statistics & numerical data, Female, Gastroschisis/physiopathology, Gastroschisis/therapy, Gestational Age, Humans, Incidence, Infant, Infant Nutritional Physiological Phenomena, Infant, Newborn, Length of Stay/statistics & numerical data, Male, Postnatal Care, Pregnancy, Prenatal Diagnosis, Proportional Hazards Models, Retrospective Studies, Sepsis/epidemiology, Statistics, Nonparametric, Time Factors
Pubmed
Web of science
Open Access
Yes
Create date
10/03/2016 18:50
Last modification date
20/08/2019 13:59
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