Associated malformations and the 鈥渉idden mortality鈥?of gastroschisis

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• 作者：Javed Akhtar^a ; ^{jakhtar_ca@yahoo.com} ; ^{jakhtar@mun.ca} ; Erik D. Skarsgard^b ; the Canadian Pediatric Surgery Network (CAPSNet)
• 关键词：Abdominal wall defects ; Gastroschisis ; Associated malformations ; Hidden mortality ; Fetal loss
• 刊名：Journal of Pediatric Surgery
• 出版年：2012
• 期刊代码：190_00223468
• 类别：med
• 出版时间：May, 2012
• 卷：47
• 期：5
• 页码：911-916
• 文件大小：182 K

摘要

Background

Little is known about associated anomalies in fetuses with gastroschisis (GS) who experience an 鈥渁typical perinatal event,鈥?defined as spontaneous abortion, stillbirth, termination, or death within 24 hours of birth.

Purpose

This study aims to compare associated malformation rates in an atypical perinatal event cohort vs newborns with GS surviving longer than 24 hours.

Methods

A national prospective GS database was analyzed for cases with an atypical perinatal event. Associated anomaly rates were compared between this cohort and babies surviving longer than 24 hours.

Results

Twenty-three atypical perinatal events (2 spontaneous abortions, 7 stillbirths, 11 terminations, and 3 deaths within 24 hours) were identified from 529 total GS cases. Autopsies in 14 (61%) of 23 identified at least 1 anomaly (excluding intestinal, patent ductus arteriosus, and undescended testicle) in 11 (78.6%) and a 鈥渓ethal鈥?anomaly in 4 (36%). The associated anomaly rate in newborns surviving longer than 24 hours was 7.3%(37/506; P < .0001). The anomalies in the atypical perinatal event cohort were musculoskeletal (35%), cardiac, central nervous system, pulmonary, and genitourinary (12%each). Among survivors, the most common anomalies were cardiac (38%), genitourinary (32%), musculoskeletal (16%), and central nervous system (8%).

Conclusion

Rates of associated anomalies are significantly higher in fetuses experiencing atypical perinatal events and may represent the 鈥渉idden mortality鈥?of GS.