Predicting the outcome of newborns with gastroschisis

Objective: The objective of the study was to determine factors predicting outcome in newborns with gastroschisis. Methods: A retrospective analysis of 155 consecutive cases admitted from 1 January 1990 to 3 1 December 2007 was performed. Prenatal ultrasound findings were available for 89 of 155 (57%) patients and were compared with final outcome. Both univariate and multiple regression analyses were used. Results: All patients survived to discharge home. The primary outcome measure was length of stay. Multiple regression identified 4 factors associated with length of stay: (1) gestational age (P = .004), (2) nonelective silo (P < .001) (3) gastrointestinal (GI) complication (intestinal atresia, perforation, or resection) (P < .001), and (4) non-GI anomaly (P = .029). Non-GI anomalies occurred in 17 of 155 (11%) patients and tended to increase the risk of a nonelective silo or GI complication (59% vs, 39%, P = .190). Dilated bowel (> 10 mm) on prenatal ultrasound was associated with GI complications (22% vs 3%, P = .010). However, 78%. of patients with dilated bowel on prenatal ultrasound did not have a GI complication. The absence of dilated bowel on prenatal ultrasound accurately predicted the absence of GI complications in 97% of cases. Conclusion: Prematurity. nonelective silo, GI complications. and non-GI anomalies predict the short-term outcome of newborns with gastroschisis. prenatal ultrasound serves primarily to predict the absence of GI complications. (c) 2009 Elscvier Inc. All rights reserved.