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Effect of gestational age at birth on neonatal outcomes in gastroschisis

Carnaghan, H; Baud, D; Lapidus-Krol, E; Ryan, G; Shah, PS; Pierro, A; Eaton, S; (2016) Effect of gestational age at birth on neonatal outcomes in gastroschisis. Journal of Pediatric Surgery , 51 (5) pp. 734-738. 10.1016/j.jpedsurg.2016.02.013. Green open access

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Abstract

INTRODUCTION: Induced birth of fetuses with gastroschisis from 34weeks gestational age (GA) has been proposed to reduce bowel damage. We aimed to determine the effect of birth timing on time to full enteral feeds (ENT), length of hospital stay (LOS), and sepsis. METHODS: A retrospective analysis (2000-2014) of gastroschisis born at ≥34weeks GA was performed. Associations between birth timing and outcomes were analyzed by Mann-Whitney test, Cox regression, and Fisher's exact test. RESULTS: 217 patients were analyzed. Although there was no difference in ENT between those born at 34-36+6weeks GA (median 28 range [6-639] days) compared with ≥37weeks GA (27 [8-349] days) when analyzed by Mann-Whitney test (p=0.5), Cox regression analysis revealed that lower birth GA significantly prolonged ENT (p=0.001). LOS was significantly longer in those born at 34-36+6weeks GA (42 [8-346] days) compared with ≥37weeks GA 34 [11-349] days by both Mann-Whitney (p=0.02) and Cox regression analysis (p<0.0005). Incidence of sepsis was higher in infants born at 34-36+6weeks (32%) vs. infants born at ≥37weeks (17%; p=0.02). CONCLUSIONS: Early birth of fetuses with gastroschisis was associated with delay in reaching full enteral feeds, prolonged hospitalization, and a higher incidence of sepsis.

Type: Article
Title: Effect of gestational age at birth on neonatal outcomes in gastroschisis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jpedsurg.2016.02.013
Publisher version: http://dx.doi.org/10.1016/j.jpedsurg.2016.02.013
Language: English
Additional information: Copyright © 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Enteral feeding, Gastroschisis, Gestational age, Neonatal outcome, Postnatal outcome, Preterm delivery
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1472971
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