The association of perinatal and clinical factors with outcomes in infants with gastroschisis-a retrospective multicenter study in Finland

Abstract

The aim of the present study was to assess the prognostic factors for the outcome of gastroschisis in Finland. A retrospective multicenter study of gastroschisis patients born between 1993 and 2015 in four Finnish university hospitals was undertaken, collecting perinatal, surgical, and clinical data of neonates for uni- and multifactorial modeling analysis. The aim of the present study was to identify risk factors for mortality and the composite adverse outcome (death and/or short bowel syndrome or hospital stay > 60 days). Of the 154 infants with gastroschisis, the overall survival rate was 90.9%. In Cox regression analysis, independent risk factors for mortality included liver herniation, pulmonary hypoplasia, relaparotomy for perforation or necrosis, abdominal compartment syndrome, and central line sepsis. Furthermore, a logistic regression analysis identified central line sepsis, abdominal compartment syndrome, complex gastroschisis, and a younger gestational age as independent predictors of the composite adverse outcome.<div><i><br /></i></div><div><i>Conclusion:</i> The risk of death is increased in newborns with gastroschisis who have liver herniation, pulmonary hypoplasia, abdominal compartment syndrome, relaparotomy for perforation or necrosis, or central line-associated sepsis. Special care should be taken to minimize the risk of central line sepsis in the clinical setting.</div><div><br /></div><div><b>What is known:</b></div><div><ul><li>Gastroschisis is a relatively rare congenital anomaly of the abdominal wall and its incidence is increasing.</li><li>Complex gastroschisis has been reported to increase risk of mortality and complications. </li></ul></div><div><b>What is new:</b></div><div><ul><li>Central line sepsis was found to be independently associated with mortality in gastroschisis patients.</li><li>Liver herniation was also significantly associated with mortality.</li></ul></div>