Valerie Y Chock1,2, Alexis S Davis3,4, Seo-Ho Cho3,5, Christina Bax6, Elizabeth Fluharty3,4, Nicole Weigel3,4, Margaret Homeyer4,7, Louanne Hudgins4,7, Richard Jones8, Erika Rubesova4,8, Karl G Sylvester4,9, Yair J Blumenfeld4,10, Susan R Hintz3,4. 1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. vchock@stanford.edu. 2. Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, 94304, USA. vchock@stanford.edu. 3. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. 4. Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, 94304, USA. 5. Stanford Prevention Research Center, Palo Alto, CA, 94305, USA. 6. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA. 7. Division of Medical Genetics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. 8. Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. 9. Department of Pediatric Surgery, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. 10. Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Stanford University School of Medicine, Palo Alto, CA, 94304, USA.
Abstract
OBJECTIVE: To characterize factors associated with adverse neonatal outcomes in prenatally diagnosed omphalocele cases. STUDY DESIGN: Prenatally diagnosed omphalocele cases at a single referral center from 1 January 2009 to 31 December 2017 were retrospectively reviewed. Clinical variables and antenatal imaging measurements were collected. Associations between prenatal and neonatal characteristics and the adverse outcome of death or prolonged length of stay (LOS) were analyzed. RESULTS: Out of 63 fetal cases, 33 were live-born, > 50% had other anomalies, and neonatal mortality was 12%. Adverse outcomes were associated with neonatal variables, including lower median 1-min Apgar score, initial mechanical ventilation, and late-onset sepsis, but not approach to omphalocele closure. With multivariate analysis, death or prolonged LOS was associated only with low lung volumes by fetal MRI (OR 34 (3-422), p = 0.006). CONCLUSION: Low lung volumes by fetal MRI were associated with death or prolonged LOS in neonates with prenatally diagnosed omphalocele and may guide clinicians with counseling families.
OBJECTIVE: To characterize factors associated with adverse neonatal outcomes in prenatally diagnosed omphalocele cases. STUDY DESIGN: Prenatally diagnosed omphalocele cases at a single referral center from 1 January 2009 to 31 December 2017 were retrospectively reviewed. Clinical variables and antenatal imaging measurements were collected. Associations between prenatal and neonatal characteristics and the adverse outcome of death or prolonged length of stay (LOS) were analyzed. RESULTS: Out of 63 fetal cases, 33 were live-born, > 50% had other anomalies, and neonatal mortality was 12%. Adverse outcomes were associated with neonatal variables, including lower median 1-min Apgar score, initial mechanical ventilation, and late-onset sepsis, but not approach to omphalocele closure. With multivariate analysis, death or prolonged LOS was associated only with low lung volumes by fetal MRI (OR 34 (3-422), p = 0.006). CONCLUSION: Low lung volumes by fetal MRI were associated with death or prolonged LOS in neonates with prenatally diagnosed omphalocele and may guide clinicians with counseling families.