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Gastroschisis with intestinal atresia leads to longer hospitalization and poor feeding outcomes

Journal of Perinatology volume 42, pages 254–259 (2022)Cite this article

Subjects

Abstract

Objective

Compare in-hospital outcomes in gastroschisis with intestinal atresia versus simple gastroschisis (GS) using a national database.

Study design

The Children’s Hospitals Neonatal Database identified infants with gastroschisis from 2010 to 2016.

Results

2078 patients with gastroschisis were included: 183 (8.8%) with co-existing intestinal atresia, 1713 (82.4%) with simple gastroschisis, the remainder with complex gastroschisis without atresia. Length of hospitalization was longer for those with atresia, and yielded higher rates of mortality, medical NEC, and intestinal perforation. They began enteral feedings later, were less likely to initiate feeds orally, and reached full feedings later. They were less likely to be receiving any maternal breast milk or breastfeeding at discharge and more likely than simple gastroschisis to be discharged with a feeding tube.

Conclusion

A large multicenter cohort showed gastroschisis with atresia results in worse outcomes and complications, including necrotizing enterocolitis, feeding delays, and enteral feeding tube dependence.

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Acknowledgements

Jeanette Asselin, David Durand (ex officio), Francine Dykes (ex officio), Jacquelyn Evans, Karna Murthy, Michael Padula, Eugenia Pallotto, Theresa Grover, Beverly Brozanski, Anthony Piazza, Kristina Reber, and Billie Short are members of the Children’s Hospitals Neonatal Consortium, Inc. (site: thechnc.org). For more information, please contact: support@thechnc.org We are indebted to the following institutions that serve the infants and their families, and these institutions also have invested in and continue to participate in the Children’s Hospital’s Neonatal Database (CHND). The site sponsors/contributors for the CHND are also included: 1 Children’s Healthcare of Atlanta, Atlanta, GA (Anthony Piazza). 2 Children’s Healthcare of Atlanta at Scottish Rite (Gregory Sysyn). 3 Children’s Hospital of Alabama, Birmingham, AL (Carl Coghill, Allison Black). 4 Le Bonheur Children’s Hospital, Memphis, TN (Ramasubbareddy Dhanireddy). 5 Children’s Hospital Boston, Boston, MA (Anne Hansen, Tanzeema Hossain). 6 Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL (Karna Murthy, Gustave Falciglia). 7 Cincinnati Children’s Hospital, Cincinnati, OH (Beth Haberman, Amy Nathan, Kristin Nelson, Paul Kingma, Stefanie Riddle, Stephanie Merhar, Heather Kaplan). 8 Nationwide Children’s Hospital, Columbus, OH (Kristina Reber). 9 Children’s Medical Center, Dallas, TX (Rashmin Savani, Luc Brion, Noorjahan Ali). 10 Children’s Hospital Colorado, Aurora, CO (Theresa Grover). 11 Children’s Hospital of Michigan, Detroit, MI (Girija Natarajan). 12 Cook Children’s Health Care System, Fort Worth, TX (Jonathan Nedrelow, Annie Chi, Yvette Johnson). 13 Texas Children’s Hospital, Houston, TX (Gautham Suresh). 14 Riley Children’s Hospital, Indianapolis, IN (William Engle, Lora Simpson, Gregory Sokol). 15 Children’s Mercy Hospitals & Clinics, Kansas City, MO (Eugenia Pallotto). 16 Arkansas Children’s Hospital, Little Rock, AR (Robert Lyle, Becky Rogers). 17 Children’s Hospital Los Angeles, Los Angeles, CA (Steven Chin, Rachel Chapman). 18 American Family Children’s Hospital, Madison, WI (Jamie Limjoco, Lori Haack). 19 Children’s Hospital & Research Center Oakland, Oakland, CA (David Durand, Jeanette Asselin, Art D’Harlingue, Priscilla Joe). 20 The Children’s Hospital of Philadelphia, Philadelphia, PA (Jacquelyn Evans, Michael Padula, David Munson). 21 St. Christopher’s Hospital for Children, Philadelphia, PA (Suzanne Touch). 22 Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (Toby Yanowitz). 23 St. Louis Children’s Hospital, St Louis, MO (Beverly Brozanski, Rakesh Rao). 24 All Children’s Hospital, St. Petersburg, FL (Victor McKay). 25 Rady Children’s Hospital, San Diego, CA (Mark Speziale, Brian Lane, Laural Moyer). 26 Children’s National Medical Center, Washington, DC (Billie Short, Lamia Soghier). 27 AI DuPont Hospital for Children, Wilmington, DE (Kevin Sullivan). 28 Primary Children’s Medical Center, Salt Lake City, UT (Con Yee Ling, Shrena Patel). 29 Children’s Hospital of Wisconsin, Milwaukee, WI (Michael Uhing, Ankur Datta). 30 Children’s Hospital & Medical Center, Omaha, NE (Nicole Birge). 31 Florida Hospital for Children (Rajan Wadhawan). 32 Seattle Children’s Hospital, Seattle, WA (Elizabeth Jacobsen-Misbe, Robert DiGeronimo, Zeenia Billimoria). 33 Hospital for Sick Children, Toronto, ON (Kyong-Soon Lee). 34 Children’s Hospital Orange County, Los Angeles, CA (Michel Mikhael, Irfan Ahmad).

Author information

Author notes

  1. A full list of members and their affiliations appears in the Supplementary Information.

Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Stefanie Riddle & Beth Haberman

  2. Arkansas Children’s Hospital and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Franscesca Miquel-Verges

  3. Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA

    Stig Somme

  4. Nemours/AI Dupont Hospital for Children, Wilmington, DE, USA

    Kevin Sullivan

  5. Department of Pediatrics of Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Kevin Sullivan

  6. Children’s Mercy Hospital and University of Missouri - Kansas City School of Medicine, Kansas, MO, USA

    Ayan Rajgarhia

  7. Children’s Hospital Association, Lenexa, KS, USA

    Isabella Zaniletti

  8. Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, WA, USA

    Elizabeth Jacobson

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  1. Stefanie Riddle
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Consortia

the Children’s Hospitals Neonatal Consortium’s Gastroschisis Focus Group

Contributions

The authors affirm that all authors have participated in the concept and design. I.Z. performed data analysis. All authors participated in interpretation of data, drafting, and revising of the manuscript, and that they have approved the manuscript as submitted.

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Correspondence to Stefanie Riddle.

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The authors declare no competing interests.

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Riddle, S., Haberman, B., Miquel-Verges, F. et al. Gastroschisis with intestinal atresia leads to longer hospitalization and poor feeding outcomes. J Perinatol 42, 254–259 (2022). https://doi.org/10.1038/s41372-021-01131-5

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