Factors associated with gastroschisis outcomes

Rachael T. Overcash, Daniel A. DeUgarte, Megan L. Stephenson, Rachel M. Gutkin, Mary E. Norton, Sima Parmar, Manuel Porto, Francis R Poulain, David B Schrimmer

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

OBJECTIVE: To identify perinatal variables associated with adverse outcomes in neonates prenatally diagnosed with gastroschisis. METHODS: A retrospective review was conducted of all inborn pregnancies complicated by gastroschisis within the five institutions of the University of California Fetal Consortium from 2007 to 2012. The primary outcome was a composite adverse neonatal outcome comprising death, reoperation, gastrostomy, and necrotizing enterocolitis. Variables collected included antenatal ultrasound findings, maternal smoking or drug use, gestational age at delivery, preterm labor, elective delivery, mode of delivery, and birth weight. Univariate and multivariate analysis was used to assess factors associated with adverse outcomes. We also evaluated the association of preterm delivery with neonatal outcomes such as total parenteral nutrition cholestasis and length of stay. RESULTS: There were 191 neonates born with gastroschisis in University of California Fetal Consortium institutions at a mean gestational age of 36 3/7±1.8 weeks. Within the cohort, 27 (14%) had one or more major adverse outcomes, including three deaths (1-6%). Early gestational age at delivery was the only variable identified as a significant predictor of adverse outcomes on both univariate and multivariate analysis (odds ratio 1.4, 95% confidence interval 1.1-1.8 for each earlier week of gestation). Total parenteral nutrition cholestasis was significantly more common in neonates delivered at less than 37 weeks of gestation (38/115 [33%] compared with 11/76 [15%]; P<001). CONCLUSION: In this contemporary cohort, earlier gestational age at delivery is associated with adverse neonatal outcomes in neonates with gastroschisis. Other variables, such as antenatal ultrasound findings and mode of delivery, did not predict adverse neonatal outcomes.

Original languageEnglish (US)
Pages (from-to)551-557
Number of pages7
JournalObstetrics and Gynecology
Volume124
Issue number3
DOIs
StatePublished - 2014

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Gastroschisis
Gestational Age
Total Parenteral Nutrition
Cholestasis
Pregnancy
Multivariate Analysis
Necrotizing Enterocolitis
Gastrostomy
Premature Obstetric Labor
Reoperation
Birth Weight
Length of Stay
Smoking
Odds Ratio
Mothers
Confidence Intervals
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Overcash, R. T., DeUgarte, D. A., Stephenson, M. L., Gutkin, R. M., Norton, M. E., Parmar, S., ... Schrimmer, D. B. (2014). Factors associated with gastroschisis outcomes. Obstetrics and Gynecology, 124(3), 551-557. https://doi.org/10.1097/AOG.0000000000000425

Factors associated with gastroschisis outcomes. / Overcash, Rachael T.; DeUgarte, Daniel A.; Stephenson, Megan L.; Gutkin, Rachel M.; Norton, Mary E.; Parmar, Sima; Porto, Manuel; Poulain, Francis R; Schrimmer, David B.

In: Obstetrics and Gynecology, Vol. 124, No. 3, 2014, p. 551-557.

Research output: Contribution to journalArticle

Overcash, RT, DeUgarte, DA, Stephenson, ML, Gutkin, RM, Norton, ME, Parmar, S, Porto, M, Poulain, FR & Schrimmer, DB 2014, 'Factors associated with gastroschisis outcomes', Obstetrics and Gynecology, vol. 124, no. 3, pp. 551-557. https://doi.org/10.1097/AOG.0000000000000425
Overcash RT, DeUgarte DA, Stephenson ML, Gutkin RM, Norton ME, Parmar S et al. Factors associated with gastroschisis outcomes. Obstetrics and Gynecology. 2014;124(3):551-557. https://doi.org/10.1097/AOG.0000000000000425
Overcash, Rachael T. ; DeUgarte, Daniel A. ; Stephenson, Megan L. ; Gutkin, Rachel M. ; Norton, Mary E. ; Parmar, Sima ; Porto, Manuel ; Poulain, Francis R ; Schrimmer, David B. / Factors associated with gastroschisis outcomes. In: Obstetrics and Gynecology. 2014 ; Vol. 124, No. 3. pp. 551-557.
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abstract = "OBJECTIVE: To identify perinatal variables associated with adverse outcomes in neonates prenatally diagnosed with gastroschisis. METHODS: A retrospective review was conducted of all inborn pregnancies complicated by gastroschisis within the five institutions of the University of California Fetal Consortium from 2007 to 2012. The primary outcome was a composite adverse neonatal outcome comprising death, reoperation, gastrostomy, and necrotizing enterocolitis. Variables collected included antenatal ultrasound findings, maternal smoking or drug use, gestational age at delivery, preterm labor, elective delivery, mode of delivery, and birth weight. Univariate and multivariate analysis was used to assess factors associated with adverse outcomes. We also evaluated the association of preterm delivery with neonatal outcomes such as total parenteral nutrition cholestasis and length of stay. RESULTS: There were 191 neonates born with gastroschisis in University of California Fetal Consortium institutions at a mean gestational age of 36 3/7±1.8 weeks. Within the cohort, 27 (14{\%}) had one or more major adverse outcomes, including three deaths (1-6{\%}). Early gestational age at delivery was the only variable identified as a significant predictor of adverse outcomes on both univariate and multivariate analysis (odds ratio 1.4, 95{\%} confidence interval 1.1-1.8 for each earlier week of gestation). Total parenteral nutrition cholestasis was significantly more common in neonates delivered at less than 37 weeks of gestation (38/115 [33{\%}] compared with 11/76 [15{\%}]; P<001). CONCLUSION: In this contemporary cohort, earlier gestational age at delivery is associated with adverse neonatal outcomes in neonates with gastroschisis. Other variables, such as antenatal ultrasound findings and mode of delivery, did not predict adverse neonatal outcomes.",
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AU - Overcash, Rachael T.

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AU - Stephenson, Megan L.

AU - Gutkin, Rachel M.

AU - Norton, Mary E.

AU - Parmar, Sima

AU - Porto, Manuel

AU - Poulain, Francis R

AU - Schrimmer, David B

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N2 - OBJECTIVE: To identify perinatal variables associated with adverse outcomes in neonates prenatally diagnosed with gastroschisis. METHODS: A retrospective review was conducted of all inborn pregnancies complicated by gastroschisis within the five institutions of the University of California Fetal Consortium from 2007 to 2012. The primary outcome was a composite adverse neonatal outcome comprising death, reoperation, gastrostomy, and necrotizing enterocolitis. Variables collected included antenatal ultrasound findings, maternal smoking or drug use, gestational age at delivery, preterm labor, elective delivery, mode of delivery, and birth weight. Univariate and multivariate analysis was used to assess factors associated with adverse outcomes. We also evaluated the association of preterm delivery with neonatal outcomes such as total parenteral nutrition cholestasis and length of stay. RESULTS: There were 191 neonates born with gastroschisis in University of California Fetal Consortium institutions at a mean gestational age of 36 3/7±1.8 weeks. Within the cohort, 27 (14%) had one or more major adverse outcomes, including three deaths (1-6%). Early gestational age at delivery was the only variable identified as a significant predictor of adverse outcomes on both univariate and multivariate analysis (odds ratio 1.4, 95% confidence interval 1.1-1.8 for each earlier week of gestation). Total parenteral nutrition cholestasis was significantly more common in neonates delivered at less than 37 weeks of gestation (38/115 [33%] compared with 11/76 [15%]; P<001). CONCLUSION: In this contemporary cohort, earlier gestational age at delivery is associated with adverse neonatal outcomes in neonates with gastroschisis. Other variables, such as antenatal ultrasound findings and mode of delivery, did not predict adverse neonatal outcomes.

AB - OBJECTIVE: To identify perinatal variables associated with adverse outcomes in neonates prenatally diagnosed with gastroschisis. METHODS: A retrospective review was conducted of all inborn pregnancies complicated by gastroschisis within the five institutions of the University of California Fetal Consortium from 2007 to 2012. The primary outcome was a composite adverse neonatal outcome comprising death, reoperation, gastrostomy, and necrotizing enterocolitis. Variables collected included antenatal ultrasound findings, maternal smoking or drug use, gestational age at delivery, preterm labor, elective delivery, mode of delivery, and birth weight. Univariate and multivariate analysis was used to assess factors associated with adverse outcomes. We also evaluated the association of preterm delivery with neonatal outcomes such as total parenteral nutrition cholestasis and length of stay. RESULTS: There were 191 neonates born with gastroschisis in University of California Fetal Consortium institutions at a mean gestational age of 36 3/7±1.8 weeks. Within the cohort, 27 (14%) had one or more major adverse outcomes, including three deaths (1-6%). Early gestational age at delivery was the only variable identified as a significant predictor of adverse outcomes on both univariate and multivariate analysis (odds ratio 1.4, 95% confidence interval 1.1-1.8 for each earlier week of gestation). Total parenteral nutrition cholestasis was significantly more common in neonates delivered at less than 37 weeks of gestation (38/115 [33%] compared with 11/76 [15%]; P<001). CONCLUSION: In this contemporary cohort, earlier gestational age at delivery is associated with adverse neonatal outcomes in neonates with gastroschisis. Other variables, such as antenatal ultrasound findings and mode of delivery, did not predict adverse neonatal outcomes.

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