Factors Affecting Survival of Newborns with Gastroschisis from a Tertiary Care Children's Hospital in India.

Abstract

<h4>Introduction</h4>The objective was to study the factors affecting the survival of newborns with gastroschisis from a tertiary care children's hospital.<h4>Materials and methods</h4>A retrospective chart review was done, wherein the data of neonates with gastroschisis managed at our tertiary care center between December 2018 and March 2024 were analyzed. Parameters noted were gestational age, birth weight, mode and center of delivery, surgical technique of closure, associated bowel atresia, need for neonatal intensive care unit (NICU) care with postoperative ventilation, and time to full feeds. The effects of different factors on overall survival were analyzed.<h4>Results</h4>Out of the total 29 patients, 21 (72.41%) survived and 8 (27.6%) expired. Male: female ratio was 3:1. Among the neonates who survived, 16/21 (76.2%) were inborn and 5/21 (23.8%) were outborn (<i>P</i> < 0.0281). The mean gestational age was 37.5 ± 0.7 weeks among the survivors and 34 ± 4.2 weeks in the non-survivors (<i>P</i> < 0.0008). Of those who survived, 19/21 (90.5%) had a birth weight of >1.5 kg versus the 5/8 (62.5%) who expired and had a birth weight ≤1.5 kg (<i>P</i> < 0.0079). Among the survivors, surgical closure was done within 24 h in 81% (17/21) versus the non-survivors in whom 75% (6/8) had surgical closure after 24 h (<i>P</i> < 0.0089). Of those who survived, 85.7% had undergone primary skin closure and 9.5% silo closure (<i>P</i> < 0.0079). All the patients received NICU care with ventilator support as required. The mean time to full feeds was 17.1 ± 4.5 days among the survivors.<h4>Conclusion</h4>Term gestational age, birth weight >1.5 kg, in-house delivery, early surgery within 24 h of delivery, and primary skin closure were associated with higher survival for gastroschisis.