Gastroschisis during gestation: prognostic factors of neonatal mortality from prenatal care to postsurgery.

OBJECTIVE

To evaluate the prognostic factors related to mortality in neonates with gastroschisis, ranging from prenatal care to corrective surgery.

STUDY

DESIGN

A retrospective cohort study was conducted and included neonates with gastroschisis who underwent surgical correction from 2010 to 2015. The patients were divided into two groups based on postoperative outcomes: those who were discharged and those who died postoperatively. Data regarding demographics, prenatal history, delivery route, surgery and postoperative outcomes were collected in both groups.

RESULTS

In total, 168 patients were eligible; 82 (48.8%) were discharged, and 86 (51.2%) died postoperatively. Fewer prenatal visits (4.85 versus 6.05 visits, P = 0.004), delayed prenatal diagnosis (27.6 versus 22.2 weeks of gestational age, P = 0.005), low birth weight (2159 versus 2444 g, P < 0.001), intestinal injury (OR 5.5, P = 0.001) and sepsis (OR 112.1, P < 0.001) were associated with infant mortality. The type of delivery and the mean time between birth and the first corrective surgery (16.2 versus 21.1 h, P = 0.071) were not associated with increased neonatal mortality; however, the newborns who underwent their first corrective surgery after less than 4 h of life had lower mortality, and surgery performed after more than 4 h of life increased the risk of mortality (OR 2.7, CI 1.2-6.3, P 0.014).

CONCLUSION

The mortality rate was high (51.2%) and was associated with inadequate prenatal care, low birth weight, gestational age, the severity of intestinal injury, infection and septicemia.