Andes pediatrica : revista Chilena de pediatria · 2025
[Prevalence and mortality factors in initial hospitalization for gastroschisis].
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Vasco-Morales Santiago, Vega-Reyes Christian, Cerón-Caicedo Antonio, Orozco-Sánchez Nicole, Vasco-Toapanta Cristhian, Toapanta-Pinta Paola
Аннотация
UNLABELLED: Gastroschisis is a congenital defect characterized by the protrusion of abdominal viscera through a paraumbilical opening.
OBJECTIVE: To determine the frequency of gastroschisis and describe variables associated with neonatal mortality.
PATIENTS AND METHOD: A cross-sectional study based on data from the Perinatal Information System of the Hospital Gineco Obstétrico Isidro Ayora (2008-2022). Sociodemographic, obstetric, and neonatal variables were analyzed using Bayesian tests for contingency tables, logistic regression, and the Bayesian t-test analog.
RESULTS: A total of 175 neonates were included (58.9% female). The frequency of gastroschisis was 0.13% (95% CI: 0.11-0.15), with a mortality rate of 22.8%. There was a negative association with gestational age (OR: 0.65; 95% CI: 0.49-0.85) and calendar year (OR: 0.79; 95% CI: 0.68-0.91), indicating lower mortality with each additional week of gestation and over time. The presence of ≥ 2 complications (OR: 3.46; 95% CI: 1.30-7.12) and Apgar score < 7 at five minutes (OR: 3.12; 95% CI: 1.01-60.91) were positively associated with mortality. Deceased neonates had lower birth weight (2,003.6g versus 2,316.7g; BF10=35.2) and shorter hospital stay (20.9 days versus 34.5 days; BF10=204).
CONCLUSIONS: Gastroschisis showed a high frequency, with mortality associated with multiple complications, low Apgar scores, and low birth weight, while higher gestational age and advances in clinical management over the years were associated with a lower fatal risk. The need for a multidisciplinary approach to improve neonatal outcomes in this population is emphasized.
OBJECTIVE: To determine the frequency of gastroschisis and describe variables associated with neonatal mortality.
PATIENTS AND METHOD: A cross-sectional study based on data from the Perinatal Information System of the Hospital Gineco Obstétrico Isidro Ayora (2008-2022). Sociodemographic, obstetric, and neonatal variables were analyzed using Bayesian tests for contingency tables, logistic regression, and the Bayesian t-test analog.
RESULTS: A total of 175 neonates were included (58.9% female). The frequency of gastroschisis was 0.13% (95% CI: 0.11-0.15), with a mortality rate of 22.8%. There was a negative association with gestational age (OR: 0.65; 95% CI: 0.49-0.85) and calendar year (OR: 0.79; 95% CI: 0.68-0.91), indicating lower mortality with each additional week of gestation and over time. The presence of ≥ 2 complications (OR: 3.46; 95% CI: 1.30-7.12) and Apgar score < 7 at five minutes (OR: 3.12; 95% CI: 1.01-60.91) were positively associated with mortality. Deceased neonates had lower birth weight (2,003.6g versus 2,316.7g; BF10=35.2) and shorter hospital stay (20.9 days versus 34.5 days; BF10=204).
CONCLUSIONS: Gastroschisis showed a high frequency, with mortality associated with multiple complications, low Apgar scores, and low birth weight, while higher gestational age and advances in clinical management over the years were associated with a lower fatal risk. The need for a multidisciplinary approach to improve neonatal outcomes in this population is emphasized.