Journal of pediatric surgery · 2013
Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study.
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Minutillo Corrado, Rao Shripada C, Pirie Simon, McMichael Judy, Dickinson Jan E
Аннотация
BACKGROUND: The aim of the study was to describe the physical growth and developmental outcomes of babies born with gastroschisis.
METHODS: We retrospectively reviewed all cases of gastroschisis in Western Australia born between 1997 and 2010.
RESULTS: In the 128 pregnancies with fetal gastroschisis, 117 babies were live born. 112 (95.7%) survived to one year. 19% had z scores of<-1.28 for weight at birth (<10th centiles) compared with 30% at one year. Neurodevelopmental data were available in 88/112 (79%) of survivors (Griffiths scores in 67; reports of ages and stages questionnaire (ASQ) in 21). The mean GQ at 12 months was 99 (SD 9.8). Suboptimal neurodevelopmental outcomes were noted in eight. Complex gastroschisis (present at birth) and acquired gut related complications were associated with adverse long term outcomes. The incidence of acquired gut complications was least (5%) in those who underwent silo reduction as the primary management. However, on univariate and multivariate analysis, the type of primary reduction did not significantly influence the outcome.
CONCLUSIONS: A large proportion of infants with gastroschisis exhibit suboptimal weight gain during the first year. The incidence of adverse developmental outcomes appears to be low.
METHODS: We retrospectively reviewed all cases of gastroschisis in Western Australia born between 1997 and 2010.
RESULTS: In the 128 pregnancies with fetal gastroschisis, 117 babies were live born. 112 (95.7%) survived to one year. 19% had z scores of<-1.28 for weight at birth (<10th centiles) compared with 30% at one year. Neurodevelopmental data were available in 88/112 (79%) of survivors (Griffiths scores in 67; reports of ages and stages questionnaire (ASQ) in 21). The mean GQ at 12 months was 99 (SD 9.8). Suboptimal neurodevelopmental outcomes were noted in eight. Complex gastroschisis (present at birth) and acquired gut related complications were associated with adverse long term outcomes. The incidence of acquired gut complications was least (5%) in those who underwent silo reduction as the primary management. However, on univariate and multivariate analysis, the type of primary reduction did not significantly influence the outcome.
CONCLUSIONS: A large proportion of infants with gastroschisis exhibit suboptimal weight gain during the first year. The incidence of adverse developmental outcomes appears to be low.
Предметные рубрики MeSH
Abnormalities, MultipleAdultComorbidityDelivery, ObstetricDevelopmental DisabilitiesDigestive System Surgical ProceduresEnteral NutritionFailure to ThriveFemaleGastroschisisGrowth DisordersHospital MortalityHospitals, PediatricHospitals, SpecialHumansInfant, NewbornInfant, PrematureInfant, Premature, DiseasesLength of StayMaleMaternal AgePostoperative ComplicationsPregnancyRetrospective StudiesSeverity of Illness IndexStillbirthSurveys and QuestionnairesSurvival RateTertiary Care CentersTreatment OutcomeWeight GainWestern AustraliaYoung Adult