Emma L Harris1, Corrado Minutillo2, Susannah Hart3, Teresa M Warner4, Madhur Ravikumara5, Elizabeth A Nathan6, Jan E Dickinson3. 1. King Edward Memorial Hospital for Women, Perth, Western Australia, Australia; Centre for Newborn Research and Education, The University of Western Australia, Perth, Western Australia, Australia. 2. Centre for Newborn Research and Education, The University of Western Australia, Perth, Western Australia, Australia; Princess Margaret Hospital for Children, Perth, Western Australia, Australia. Electronic address: corrado.minutillo@health.wa.gov.au. 3. School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia. 4. King Edward Memorial Hospital for Women, Perth, Western Australia, Australia. 5. Princess Margaret Hospital for Children, Perth, Western Australia, Australia. 6. Women and Infants Research Foundation, Perth, Western Australia, Australia.
Abstract
PURPOSE: To determine the progress, physical and metabolic outcomes of gastroschisis survivors. METHODS: Fifty children born with gastroschisis were assessed with a health questionnaire, physical assessment, bone density and nutritional blood parameters at a median age of 9years (range 5-17). RESULTS: After initial abdominal closure, 27/50 (54%) required additional surgical interventions. Ten (20%) children had complex gastroschisis (CG). Abdominal pain was common: weekly in 41%; and requiring hospitalization in 30%. The weight, length and head circumference z-scores improved by a median 0.88 (p=0.001), 0.56 (p=0.006) and 0.74 (p=0.018) of a standard deviation (SD) respectively from birth; 24% were overweight or obese at follow up. However, those with CG had significantly lower median weight z-scores (-0.43 v 0.49, p=0.0004) and body mass index (BMI) (-0.48 v 0.42, p=0.001) at follow up compared to children with simple gastroschisis. Cholesterol levels were elevated in 24% of children. Bone mineral density was reassuring. There were 15 instances of low blood vitamin and mineral levels. CONCLUSIONS: Although gastroschisis survival levels are high, many children have significant ongoing morbidity. Children with simple gastroschisis showed significant catch up growth and a quarter had become overweight.
PURPOSE: To determine the progress, physical and metabolic outcomes of gastroschisis survivors. METHODS: Fifty children born with gastroschisis were assessed with a health questionnaire, physical assessment, bone density and nutritional blood parameters at a median age of 9years (range 5-17). RESULTS: After initial abdominal closure, 27/50 (54%) required additional surgical interventions. Ten (20%) children had complex gastroschisis (CG). Abdominal pain was common: weekly in 41%; and requiring hospitalization in 30%. The weight, length and head circumference z-scores improved by a median 0.88 (p=0.001), 0.56 (p=0.006) and 0.74 (p=0.018) of a standard deviation (SD) respectively from birth; 24% were overweight or obese at follow up. However, those with CG had significantly lower median weight z-scores (-0.43 v 0.49, p=0.0004) and body mass index (BMI) (-0.48 v 0.42, p=0.001) at follow up compared to children with simple gastroschisis. Cholesterol levels were elevated in 24% of children. Bone mineral density was reassuring. There were 15 instances of low blood vitamin and mineral levels. CONCLUSIONS: Although gastroschisis survival levels are high, many children have significant ongoing morbidity. Children with simple gastroschisis showed significant catch up growth and a quarter had become overweight.
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