Outcomes of infants with abdominal wall defects over 18years

Juin Yee Kong; Kee Thai Yeo; Mohamed E Abdel-Latif; Barbara Bajuk; Andrew J A Holland; Susan Adams; Ashish Jiwane; Sandra Heck; Michael Yeong; Kei Lui; Ju Lee Oei; New South Wales and Australian Capital Territory Neonatal Intensive Care Units' Data Collection

doi:10.1016/j.jpedsurg.2016.06.003

Outcomes of infants with abdominal wall defects over 18years

J Pediatr Surg. 2016 Oct;51(10):1644-9. doi: 10.1016/j.jpedsurg.2016.06.003. Epub 2016 Jun 13.

Affiliations

¹ Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia; Department of Neonatology, KK Women's and Children's Hospital, Singapore. Electronic address: kong.juin.yee@kkh.com.sg.
² Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia; Department of Neonatology, KK Women's and Children's Hospital, Singapore.
³ Department of Neonatology, Centenary Hospital for Women and Children, Garran, ACT, Australia; School of Clinical Medicine, Australian National University, Woden, ACT, Australia.
⁴ Neonatal Intensive Care Units' Data Collection, NSW Pregnancy and Newborn Services Network, Westmead, NSW, Australia.
⁵ The Children's Hospital at Westmead, The University of Sydney, NSW, Australia;; School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia;
⁶ School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia;; Department of Pediatric Surgery, Sydney Children's Hospital, Randwick, NSW, Australia.
⁷ The Children's Hospital at Westmead, The University of Sydney, NSW, Australia;
⁸ Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia.
⁹ Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia;

PMID: 27364305
DOI: 10.1016/j.jpedsurg.2016.06.003

Abstract

Background/purpose: Infants with abdominal wall defects (AWD) are at risk of poor outcomes including prolonged hospitalization, infections and mortality. Our objective was to describe and compare the outcomes of infants admitted with gastroschisis and omphalocele over 18years.

Methods: Population-based study of clinical data and outcomes of live-born infants with AWD admitted to all tertiary-level neonatal intensive care units in New South Wales and Australian Capital Territory from 1992 to 2009.

Result: There were 502 infants with AWD - 336 gastroschisis, 166 omphalocele. Infants with gastroschisis required a longer duration of total parenteral nutrition (19 vs 4days, p<0.05), longer hospitalization (28 vs 15days, p<0.05) and had a higher rate of systemic infection [23.5% vs 13.3%, OR 1.77 (1.15-2.74), p<0.05] compared to infants with omphalocele. Overall, omphalocele infants had higher mortality rate compared to gastroschisis infants [OR 2.77 (1.53, 5.04), p<0.05]. Gastroschisis mortality rates increased from epoch 1 to epoch 3 (4.2% to 8.8%).

Conclusion: Compared to infants with omphalocele, infants with gastroschisis required significantly longer hospitalization and parenteral nutrition with higher rates of infection. Infants with omphalocele had higher overall mortality rates. However, there has been an increase in the gastroschisis mortality rates but the cause for this is unclear.

Keywords: Abdominal wall defect; Gastroschisis; Mortality; Neonate; Omphalocele; Outcomes.

Publication types

Multicenter Study

MeSH terms

Abdominal Wall
Female
Forecasting*
Gastroschisis / epidemiology*
Gastroschisis / surgery*
Hernia, Umbilical / epidemiology*
Hernia, Umbilical / surgery*
Humans
Infant, Newborn
Intensive Care Units, Neonatal*
Male
Morbidity / trends
New South Wales
Survival Rate / trends