Gastroschisis annual incidence, mortality, and trends in extreme Southern Brazil (original) (raw)
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Scientific Reports
To estimate the gastroschisis seasonality and trend of prevalence in recent years, stratified by maternal age and geographical clusters of São Paulo state, a population–based study was designed. We used data from the Live Births Information System (SINASC) in São Paulo state, Brazil, from 2005 to 2016. Trends of prevalence were evaluated for the specific subgroups using the Prais–Winsten regression model, and the Durbin–Watson test was used, to estimate the regression coefficient, the annual percent change (APC), and 95% confidence interval (CI). We observed 1576 cases of gastroschisis among 7,317,657 live births (LB), a prevalence of 2.154 (95% CI: 2.047–2.260) per 10,000 LB which included, 50.6% males, 67.4% Caucasians, 53.4% preterm births, and 80.9% caesarean births. The prevalence of gastroschisis significantly increased by 2.6% (95% CI: 0.0–5.2) per year, and this trend was higher in mothers aged 30–34 years (APC: 10.2, 95% CI: 1.4–19.4) than in mothers of other age groups. Be...
Profile of Newborns with Gastroschisis Diagnosis in a Public Hospital at Porto Alegre/RS
Clinical & Biomedical Research, 2017
Objective: To know the profile of newborn diagnosed with gastroschisis and treated at a public hospital at Porto Alegre, southern Brazil. Method: A cross-sectional, descriptive, quantitative study was conducted to retrospectively analyze 54 medical records of neonates diagnosed with gastroschisis treated at the study hospital between January 2006 and January 2016. The analysis included all medical records of infants diagnosed with gastroschisis and born in the institution studied, as well as those who were transferred from other health institutions in the period examined. Medical records were searched through electronic consultation to the institution's Epidemiology Service, using the International Code of Diseases (ICD) 10 Q 793). Later, the files were accessed through the Medical Records and Statistics Service. Information was collected using a form containing the study variables. The data analysis was performed using SPSS software, version 21.0. The study complied with the ethical aspects of human research legislation. Results: The prevalence of gastroschisis was 0.11%, totaling 54 cases identified. Mean maternal age was 20.2 years; sex distribution was equal among newborns with the malformation; and 72.5% of cases had primary abdominal closure. Conclusion: The results for related causes and treatment, such as maternal age, drug use, and type of abdominal closure, were similar to findings from other studies on gastroschisis.
Outcome of Gastroschisis in a Developing Country: Where to Focus?
The Journal of medical research, 2017
Background: Gastroschisis is a common congenital anterior abdominal wall defect. With the advancement of neonatal care outcome of gastroschisis is improving worldwide but the result is disappointing in our center. Several factors adversely affect the outcome. The aim of this study was to identify the factors influencing the adverse outcome and where to focus to improve the situation. Materials and methods: It was a retrospective analytical study done in Dhaka Shishu (Children) Hospital from March 2014 to April 2017. Data were collected from hospital record. All patients admitted with gastroschisis during the study period were included and grouped into A (survived) and B (expired). Factors influencing the outcome were compared between two groups. Statistical analysis was done using
African Journal of Paediatric Surgery, 2015
Background: The aim was to compare gastroschisis (GS) epidemiology, management and outcome in low-income countries (LIC) in Sub-Saharan Africa (SSA) with middle-(MIC) and high-income countries (HIC). Materials and Methods: A 10-question survey was administered at the 2012 Pan-African Paediatric Surgery Association Congress. Results are presented as median (range); differences were analysed using contingency tests. Results: A total of 82 delegates (28 countries [66 institutions]) were divided into LIC (n = 11), MIC (n = 6) and HIC (n = 11). In LIC, there were fewer surgeons and more patients. LIC reported 22 cases (1-184) GS/institution/year, compared to 12 cases (3-23)/institution/year in MICs and 15 cases (1-100)/institution/year in HICs. Antenatal screening was less readily available in LIC. Access to parenteral nutrition and neonatal intensive care in LIC was 36% and 19%, compared to 100% in HIC. Primary closure rates were similar in LIC and HIC at 58% and 54%, respectively; however, the majority of staged closure utilised custom silos in LIC and preformed silos in HIC. In LIC, mortality was reported as >75% by 61% delegates and 50-75% by 33%, compared to <25% by 100% of HIC delegates (P < 0.0001). Conclusions: Gastroschisis is a problem encountered by surgeons in SSA. Mortality is high and resources in many centres inadequate. We propose the implementation of a combined epidemiological research, service delivery training and resource provision programme to help improve our understanding of GS in SSA whilst attempting to improve outcome.
Gastroschisis: factors influencing 3-year survival and digestive outcome
2015
Background: Gastroschisis patients’ morbidity is still high, underlining the importance of identifying factors associated with adverse outcomes. Objective: To determine factors influencing gastroschisis patients’ morbimortality during the first 3 years of life in “Centro Hospitalar Sao Joao” (CHSJ). Methodology: Records of infants born with gastroschisis between January 2002 and December 2011 admitted to CHSJ were reviewed. The relation between demographic and clinical data and morbimortality during the first 3 years of life, specifically anthropometric evolution and digestive outcome, was evaluated. The factors that were compared were simple versus complex gastroschisis and primary versus secondary closure. Results: Forty records were analysed. The survival rate was 92.3%. Patients with complex gastroschisis had worse outcomes: hospital stay (median 59 versus 23.5 days), total parenteral nutrition (50 versus 19 days), total oral intake reached (47 versus 22.5 days), morphine analge...
EC Paediatrics, 2021
Gastroschisis is a congenital anomaly in which the intestine and other abdominal contents protrude through a paraumbilical defect of the anterior abdominal wall. The objective of this work was to associate the GPS score with morbidity and mortality in newborns with gastroschisis in 4 hospitals in the state of Puebla, as well as to analyze the causes of these cases according to the scale. A retrospective, multicenter cohort study was carried out in four hospital centers in the city of Puebla. Each of the records of newborns diagnosed with gastroschisis during the period from March 2014 to December 2019 was analyzed. It was possible to conclude that there exists an association with statistical significance between the GPS score with the causes of morbidity and mortality.
Assessment of gastroschisis risk factors in Egypt
Journal of Pediatric Surgery, 2020
Gastroschisis Abdominal wall defect Low income country Egypt Africa Aim: Mortality in infants born with gastroschisis (GS) in low-to-middle-income countries (LMICs) is high. This study aimed to assess factors which might affect outcome in Egypt in order to improve survival. Methods: A prospective study over a 15-month duration was completed. Variables assessed covered patient, maternal, antenatal, treatment, and complications. The Gastroschisis Prognostic Score (GPS) was used to predict outcome. A validated questionnaire was used to assess socioeconomic status. The main outcome was mortality. Results: Twenty-four cases were studied. Median gestational age was 37 (26-40) weeks, and 9 (38%) were preterm. Mortality occurred in 15 (62%) infants. Median transfer time was 8 (1.5-35) hours, and 64% survived if transferred before 8 h. Median maternal age was 20 (16-27) years. All families were of a low or very-low socioeconomic level. Only 25% had antenatal scans. Most cases were simple GS, and only 3 (12.5%) were complex GS. Median length of stay was 14 (1-52) days, TPN duration was 12 (0-49) days, and days to full feeds was 5 (3-11) days. The GPS score ranged from 0 to 6 in the studied cases and negatively correlated with outcome (r S = −0.98; p = 0.03). Conclusion: The mortality of GS in Egypt is very high, mainly due to sepsis and prematurity. Young maternal age and poor socioeconomic status are linked to GS. The GPS is a good indicator of morbidity and mortality in a LMIC setting. Survival improved with better resuscitation and strict management protocols. More effort is needed to improve antenatal detection, and transfer time should be ideally below 8 h.
11-YEAR Experience with Gastroschisis: Factors Affecting Mortality and Morbidity
Iranian journal of pediatrics, 2012
The aim of the study was the evaluation of patients treated with a diagnosis of gastroschisis and to establish the factors which affected the morbidity and mortality. Twenty-nine patients, managed for gastroschisis during 2000-2010 were reviewed retrospectively. Patients were analysed in respect to gestational age, birth weight, associated anomalies, type of delivery, operative procedures, postoperative complications, total parenteral nutrition (TPN) related complications. The factors affecting mortality and morbidity were determined. Associated abnormalities were present in 24% of the patients. Eleven patients underwent elective reduction in the incubator (Bianchi procedure) without anesthesia. Eight patients had delayed reduction with silo and ten patients had primary closure. Although the type of delivery had an effect on morbidity but not mortality, gestational age, birth weight, and the operative procedure performed had no effect on morbidity or mortality. Duration until tolera...
Risk factors for gastroschisis
Teratology, 1990
The prevalence at birth of gastroschisis, a rare abnormality of the abdominal wall, appears to have increased over the past decade. To characterize risk factors that might explain this increase, birth certificates for Washington State residents were compared for 62 infants born with gastroschisis during the years 1984 to 1987 and 617 randomly selected unaffected infants matched for birth year. After simultaneously adjusting for 14 potential risk factors, 4 factors stood out. Infants born during January, February, or March were at greater risk than infants born in any other months (odds ratio 2.2,95% confidence interval 1.1,4.1). Mothers less than 25 years old were at greater risk than mothers 25 years and older, with the highest risk to mothers less than 20 years old (odds ratio 4.1,95% confidence interval 1.4,12.0). Women who smoked during pregnancy were at greater risk than women who did not smoke (odds ratio 2.0, 95% confidence interval 1.03, 3.8). Finally, mothers receiving inadequate prenatal care were at greater risk than mothers receiving adequate prenatal care (odds ratio 2.1, 95% confidence interval 0.99, 4.6). Unidentified behavioral and environmental exposures may explain the associations with month of birth, maternal age, and prenatal care. However, smoking during pregnancy is a plausible risk factor that should be examined further as an explanation of the apparently increasing prevalence at birth of gastroschisis in developed nations.