695 - Do near term infants with gastroschisis have better outcomes than full term infants?
Monday, April 28, 2025
7:00am – 9:15am HST
Publication Number: 695.4290
Melissa Andrianov, Cleveland Clinic Children's Hospital, Cleveland, OH, United States; Mohsen A.A.. Farghaly, Cleveland Clinic Children's, Cleveland, OH, United States; Marwa M. Elgendy, University of Florida, Jacksonville, FL, United States; Hatem Eltaly, Cleveland Clinic Children's, Cleveland, OH, United States; Mohamed A. Mohamed, Cleveland Clinic Children's, Cleveland, OH, United States; Hany Aly, Cleveland Children’s Hospital, Cleveland, OH, United States
Neonatology staff physician Cleveland Clinic Children's Hospital Cleveland, Ohio, United States
Background: Data from Canadian neonatal network reported that the outcomes of infants with gastroschisis who are delivered prematurely at 35-36 weeks may be improved compared to infants with gastroschisis born at term. Objective: To examine the prevalence of necrotizing enterocolitis (NEC), length of hospital stay (LOS), and mortality associated with gastroschisis in near term versus term infants. Design/Methods: We used the National Inpatient Sample (NIS) dataset produced by the healthcare cost and utilization project (HCUP) for the years 2016-2020. We identified clinical diagnoses using respective international classification of diseases version 10 (ICD10). We identified gastroschisis using ICD10: Q79.3. We included all infants diagnosed with gastroschisis. To examine morbidities and mortalities among infants with gastroschisis, we excluded infants < 34 weeks gestational age (GA), or birth weight (BW) < 1500g , infants with Trisomy 13 or 18, infants with complex congenital heart disease (CHD), congenital diaphragmatic hernia (CDH), severe brain anomalies or neural tube defects (NTD). We compared outcomes of gastroschisis between different GA categories using logistic regression models to controlled for potential confounding variables. Results: Weighted sample included 18,973,800 infants born in the years 2016-2020. There were 9271 infants with gastroschisis (0.05%). Prevalence of gastroschisis was 0.02%, 0.34%, 0.43%, and 0.34% in infants > 37, 36, 35, and 34 weeks (wk) GA, respectively. Of the infants with gastroschisis, the same was described as has 48.1% females, 47.6% Caucasian, 98.3% singleton, and 8.85% small for gestational age. The prevalence of NEC among infants with gastroschisis was 6.61%. Infants 34wk and 35wk GA had significantly higher incidence of NEC compared to term infants (>37wk) but not 36wk infants. Median length of stay was 29 days and it was significantly higher in infants 34-35wk compared to term infants. Mortality occurred in 2.03% of infants with gastroschisis and it did not statistically differ between groups, except it was higher in infants 34wk compared to term infants, see table 1
Conclusion(s): Infants with gastroschisis, if delivered near term at 34-35 weeks GA, have a higher incidence of NEC and a longer LOS compared to term infants (>37 weeks GA). Mortality did not significantly differ between groups, except in infants delivered at 34 weeks, which was found to be higher.
