OBJECTIVE: The aim of the study was to examine the short-term outcome of infants with gastroschisis by route of delivery, comparing vaginal delivery vs elective and emergency cesarean delivery (CD). METHODS: Six hundred thirty-one infants with gastroschisis (International Classification of Diseases, 10th Revision: Q79.3) were admitted to the Australian and New Zealand Neonatal Network during 1997 to 2005. Multivariate Cox proportional hazards regression analysis was performed to adjust for case-mix and significant baseline characteristics. RESULTS: During the study period, 631 infants with gastroschisis were admitted to the collaborating centers. Of these, 343 (54.4%) infants were delivered vaginally, whereas 288 (45.6%) were delivered by cesarean birth. Of the latter, 148 (23.4%) were elective and 140 (22.2%) were emergency. There was an increasing trend of CD from 41.1% in 1997 to 69.0% in 2005. Forty-seven (7.4%) infants died; 30 (8.7%) in the vaginal, 9 (6.4%) in the emergency, and 8 (5.4%) in the elective CD group. There was no difference in rate of proven infection, duration of ventilation, or length of neonatal intensive care unit stay between the 3 groups. After controlling for prematurity, low birth weight, and outborn birth, the risk for neonatal demise was similar in both the vaginal and CD infants (adjusted hazard ratio, 1.486; 95% confidence interval, 0.814-2.713; P = .197). Stratifying the CD (emergency vs elective) gave similar results. CONCLUSION: Infants with gastroschisis appear to be safely delivered vaginally.
OBJECTIVE: The aim of the study was to examine the short-term outcome of infants with gastroschisis by route of delivery, comparing vaginal delivery vs elective and emergency cesarean delivery (CD). METHODS: Six hundred thirty-one infants with gastroschisis (International Classification of Diseases, 10th Revision: Q79.3) were admitted to the Australian and New Zealand Neonatal Network during 1997 to 2005. Multivariate Cox proportional hazards regression analysis was performed to adjust for case-mix and significant baseline characteristics. RESULTS: During the study period, 631 infants with gastroschisis were admitted to the collaborating centers. Of these, 343 (54.4%) infants were delivered vaginally, whereas 288 (45.6%) were delivered by cesarean birth. Of the latter, 148 (23.4%) were elective and 140 (22.2%) were emergency. There was an increasing trend of CD from 41.1% in 1997 to 69.0% in 2005. Forty-seven (7.4%) infants died; 30 (8.7%) in the vaginal, 9 (6.4%) in the emergency, and 8 (5.4%) in the elective CD group. There was no difference in rate of proven infection, duration of ventilation, or length of neonatal intensive care unit stay between the 3 groups. After controlling for prematurity, low birth weight, and outborn birth, the risk for neonatal demise was similar in both the vaginal and CD infants (adjusted hazard ratio, 1.486; 95% confidence interval, 0.814-2.713; P = .197). Stratifying the CD (emergency vs elective) gave similar results. CONCLUSION:Infants with gastroschisis appear to be safely delivered vaginally.
Authors: Carmen Mesas Burgos; Anna Svenningsson; Jenny Hammarqvist Vejde; Tina Granholm; Peter Conner Journal: Pediatr Surg Int Date: 2015-09-23 Impact factor: 1.827
Authors: Adriana Lopez; Renata H Benjamin; Janhavi R Raut; Anushuya Ramakrishnan; Laura E Mitchell; Kuojen Tsao; Anthony Johnson; Peter H Langlois; Michael D Swartz; A J Agopian Journal: Paediatr Perinat Epidemiol Date: 2019-05-14 Impact factor: 3.980
Authors: Allison J Wu; David J Lee; Fan Li; Nicole H Tobin; Grace M Aldrovandi; Stephen B Shew; Kara L Calkins Journal: JPEN J Parenter Enteral Nutr Date: 2020-06-26 Impact factor: 3.896
Authors: C C M M Lap; L R Pistorius; E J H Mulder; M Aliasi; W L M Kramer; C M Bilardo; T E Cohen-Overbeek; E Pajkrt; D Tibboel; R M H Wijnen; G H A Visser; G T R Manten Journal: Ultrasound Obstet Gynecol Date: 2020-06 Impact factor: 7.299