Effect of gestational age at birth on neonatal outcomes in gastroschisis

IntroductionInduced birth of fetuses with gastroschisis from 34 weeks gestational age (GA) has been proposed to reduce bowel damage. We aimed to determine the effect of birth timing on time to full enteral feeds (ENT), length of hospital stay (LOS), and sepsis.MethodsA retrospective analysis (2000-2014) of gastroschisis born at ≥ 34 weeks GA was performed. Associations between birth timing and outcomes were analyzed by Mann-Whitney test, Cox regression, and Fisher's exact test.Results217 patients were analyzed. Although there was no difference in ENT between those born at 34-36 + 6 weeks GA (median 28 range [6-639] days) compared with ≥ 37 weeks GA (27 [8-349] days) when analyzed by Mann-Whitney test (p = 0.5), Cox regression analysis revealed that lower birth GA significantly prolonged ENT (p = 0.001). LOS was significantly longer in those born at 34-36 + 6 weeks GA (42 [8-346] days) compared with ≥ 37 weeks GA 34 [11-349] days by both Mann-Whitney (p = 0.02) and Cox regression analysis (p < 0.0005). Incidence of sepsis was higher in infants born at 34-36 + 6 weeks (32%) vs. infants born at ≥ 37 weeks (17%; p = 0.02).ConclusionsEarly birth of fetuses with gastroschisis was associated with delay in reaching full enteral feeds, prolonged hospitalization, and a higher incidence of sepsis.