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Management and outcome challenges in newborns with gastroschisis: A 6-year retrospective French study.
- Source :
- Journal of Maternal-Fetal & Neonatal Medicine; Dec2017, Vol. 30 Issue 23, p2864-2870, 7p
- Publication Year :
- 2017
-
Abstract
- <bold>Objective: </bold>To identify the gestational age (GA) at which risk of mortality and severe outcome was minimized comparing preterm delivery and expectant management.<bold>Methods: </bold>Retrospective study performed between 2009 and 2014 of newborns with gastroschisis in three large French level III neonatal intensive care units. Each department followed two distinct strategies: elective delivery at 35 weeks' GA and a delayed approach.<bold>Results: </bold>We included 69 gastroschisis cases. The lengths of stay lasting more than 60 days were significantly greater in the planned delivery group than in the expectant approach group (18/30 (60%) vs. 8/39 (20.5%), p = 0.001). Gastroschisis cases receiving antenatal corticoids during the last two weeks of gestation required significantly less surgeries during their initial stay (p = 0.003) as well as shorter parenteral feedings (p = 0.002). A multivariate logistic regression showed that a GA of less than 36 weeks' GA was is a pejorative factor for a stay above 60 days, regardless of whether it was a simple or complex gastroschisis, (OR= 3.8; p = 0.021). A complex gastroschisis was a risk factor for significantly longer parenteral feedings, regardless of the center where patient is treated (Beta = -0.3, p = 0.035).<bold>Conclusions: </bold>Future research should focus on decisions about delivery timing by incorporating risk of neonatal morbidity. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14767058
- Volume :
- 30
- Issue :
- 23
- Database :
- Complementary Index
- Journal :
- Journal of Maternal-Fetal & Neonatal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 125458114
- Full Text :
- https://doi.org/10.1080/14767058.2016.1265935