Postnatal outcome in gastroschisis: effect of birth weight and gestational age

Introduction: Early elective delivery of antenatally diagnosed gastroschisis has been proposed as a strategy to minimize postnatal morbidity. This hypothesis was tested by analyzing outcome in relationship to gestational age and birth weight at delivery. Methods: Single-center retrospective review of infants born with gastroschisis over a 13-year period (January 1993-December 2005). Standard outcome measures were compared using nonparametric methods. Data are quoted as median values (range). Results: The study population consisted of 110 infants with gastroschisis. They were divided according to gestational age (group A, < 35 weeks; group B, 35-37 weeks; group C, > 37 weeks) and birth weight (group D, < 2 kg; group E, 2-2.5 kg; group F, > 2.5 kg). Duration in hospital (P < .01) and time to full enteral feeding (P = .05) was increased in group A vs groups B and C. In comparison, duration in hospital (P < .01), days ventilated (P = .03), establishment of full feeds (P = .01), and parentral nutrition (P = .02) were all prolonged in group D vs groups E and F. Six (5%) infants died (group D, n = 3; group E, n = 3). Necrotizing enterocolitis was found in 7 infants, and confined to groups D and E (chi(2) for trend P = .06). Conclusion: There is no evidence that prematurity confers an advantage in restitution of gastrointestinal function in infants with gastroschisis; indeed, the opposite appears true. Birth weight, rather than gestational age, appears a better predictor of outcome. (C) 2007 Elsevier Inc. All rights reserved.