Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas

Eggink, B. Hannie; Richardson, C. Joan; Malloy, Michael H.; Angel, Carlos

doi:10.1016/j.jpedsurg.2006.02.008

Cited by 73 publications

(73 citation statements)

References 41 publications

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“…2,3 The most common neonatal morbidities associated with gastroschisis include gastroesophageal reflux disease (GERD), feeding intolerance due to prolonged intestinal dysmotility and sepsis. 4 Infants with gastroschisis frequently have risk factors for impaired growth and delayed neurodevelopment, including premature birth, small for gestational age (SGA) or nutritional compromise early in life. 5 Approximately 67% of infants with gastroschisis are born prematurely, 6 20% are SGA, 7 and 15 to 20% experience prolonged intestinal dysfunction requiring parenteral nutrition for longer than 4 weeks.…”

Section: Introductionmentioning

confidence: 99%

Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis

et al. 2008

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Objective: To examine growth, neurodevelopment and morbidity in infants with gastroschisis. Study Design:We enrolled all infants with gastroschisis treated at the North Carolina Children's Hospital from March 2003 through June 2005. Neonatal data were collected. Medical history, growth and neurodevelopment were assessed at 16 to 24 months.Result: Of 24 infants, 17 completed follow-up. Weight and length were below the 10th percentile for five and six infants, respectively. Three infants scored less than 85 on the Bayley Scales of Infant Development, second edition. Small for gestational age (SGA) infants were smaller and had lower neurodevelopmental scores. Fourteen experienced continued bowel dysfunction; nine were rehospitalized. Conclusion:One-third of infants with gastroschisis experience growth delay. Infants who are SGA are at higher risk, suggesting that postnatal growth may be influenced by fetal phenomena, and may not be modifiable. Neurodevelopment is not delayed. Continued bowel dysfunction is common.

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Section: Introductionmentioning

confidence: 99%

Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis

et al. 2008

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“…[16][17][18] Our data showed clear benefit to early attempted primary closure for both LOS and duration of TPN. Earlier studies have indicated that the cost of urgent closure may be a prolonging of mechanical ventilation 19; however, we did not observe an increase in the duration of mechanical ventilation in infants undergoing urgent closure.…”

Section: Discussionmentioning

confidence: 63%

Perinatal predictors of outcome in gastroschisis

et al. 2010

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Objective: To identify perinatal risk variables predictive of outcome in gastroschisis.Study Design: Gastroschisis cases were collected over a 3-year period from a national database. Risk variables evaluated included gestational age (GA), birth weight, time of birth, admission illness severity (score for neonatal acute physiology-II, SNAP-II) score, and abdominal closure type. Mortality and survival outcomes were analyzed. Multivariate analyses were performed.Result: In all, 239 infants were survived (96%). SNAP-II score predicted mortality (relative risk (RR) ¼ 1.07, 95% confidence interval (CI) ¼ 1.0 to 1.1). Length of hospital stay (LOS) and ventilation days were predicted by GA and by SNAP-II score. SNAP-II score predicted total parenteral nutrition (TPN) days (P ¼ 0.006). Severe cholestasis (conjugated bilirubin of >10 mg per 100 ml) was inversely related to GA (RR ¼ 0.77, 95% CI ¼ 0.61 to 0.97) and directly to categorical SNAP-II score (RR ¼ 3.4, 95% CI ¼ 1.2 to 10.1). Urgent closure predicted fewer TPN days (P ¼ 0.003) and shorter LOS (P ¼ 0.0002).Conclusion: SNAP-II scores significantly predict mortality and survival outcomes. Urgent closure favors fewer TPN days and shorter LOS. Our data refute routine preterm delivery in gastroschisis.

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“…The reported incidence of gastroschisis ranges from 0.4 to 11.7 cases per 10,000 live births, and studies in Japan, the United States and Europe have indicated that the incidence has markedly increased in all maternal age groups over the past two decades [31][32][33][34][35][36][37][38]. Gastroschisis is a congenital condition with survival of greater than 90% [39], although most patients with gastroschisis have initial gut dysmotility and require parenteral nutrition.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of Dai-kenchu-to in postoperative infants with gastroschisis

Otake¹,

Uchida²,

Koike³

et al. 2012

OJPed

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Purpose: Intestinal dysfunction is a major problem after gastroschisis repair, and causes poor oral intake and poor body weight gain in infants with gastroschisis. Dai-kenchu-to (DKT) is often used in the treatment of gastrointestinal dysfunction in Japan. The purpose of this study was to analyze the effect of DKT on infants with uncomplicated gastroschisis. Methods: In this retrospective cohort study from 1991 to 2009, we assessed 16 infants with uncomplicated gastroschisis. Eight infants received 0.3 g/kg/day of DKT for 12 months (group 1) and 8 infants did not receive DKT (group 2). We analyzed their body weight as an indicator of the effect of DKT. Results: There were no significant differences in the background characteristics. The body weight of group 1 was significantly increased at the ages of 9 months (p = 0.0348) and 12 months (p = 0.0097), compared with group 2. Multivariate analyses revealed that only DKT administration had a significant impact on body weight gain at the ages of 9 months (p = 0.0201) and 12 months (p = 0.0111). No side effects related to DKT were reported. Conclusion: DKT administration might worksafely and effectively for improvingthe body weight gain in infants with uncomplicated gastroschisis.

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Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas

Cited by 73 publications

References 41 publications

Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis

Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis

Perinatal predictors of outcome in gastroschisis

Safety and efficacy of Dai-kenchu-to in postoperative infants with gastroschisis

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